Tinea Clinical Trial
Official title:
Oxiconazole Nitrate Solid Lipid Nanoparticles : Formulation, In-vitro Characterization and Clinical Assessment of An Analogous Loaded Carbopol Gel
Clinical study for the developed oxiconazole nitrate solid lipid nanoparticles (SLNs) gel system compared to the corresponding marketed product was conducted on 28 patients with different types of tinea fungal infection.
The clinical work has been carried out in accordance with The Code of Ethics of the World
Medical Association for experiments involving humans. The study was conducted on 28 patients
(12 to 50 years old) with tinea of different types attending the dermatology department
outpatient clinic of Minia University Hospital. Local institutional review board approval was
obtained for this study (ethical approval number is 23/12). Pregnant females and patients
with Immunocompromising disease,open wounds and psychological disorders were excluded.
Patients were subjected to skin irritation test by applying gel on an area of 2 square inch
to the back of hand. Then, examination for the presence of lesion or irritation was
conducted. The patients divided into two groups of 14 patients each. Tinox® group was male
patients from 12 to 43 years old. The included cases were 5 tinea pedis, 9 tinea versicolor.
Oxiconazole nitrate SLNs loaded gel group was 13 males and one female from17 to 50 years old.
The included cases were 3 tinea pedis, 8 tinea versicolor, 3 tinea circinate. An informed
consent has been obtained from all patients enrolled in the study for photography and
treatment. History, general local examination and laboratory investigation for all patients
were conducted.The patients were clinically examined after determining the type of infection.
Tinox® group was treated with Tinox® cream 1 % while oxiconazole nitrate SLNs loaded gel
group was treated with the oxiconazole nitrate SLNs-loaded gel. Treatment was performed by
rubbing the cream or gel twice daily for two/ four weeks according to different types of
tinea. Patients were advised to avoid sun exposure between 10 am and 4 pm and avoid removal
of the applied dose during the period of follow up, the clinical improvement of the patients
and length of treatment was assessed according to quartile grading scale patient
satisfaction. It was rated by the patient and the physician as excellent, good, fair and poor
according to the following criteria. Excellent: both the patient and the physician agreed
that the result was satisfactory. Good: the result although acceptable was not quite up to
expectation of the patient, but the physicians were pleased with the outcome. Fair: the
improvement was evaluated by both the patient and the physician to be less than expected but
still with same improvement. Poor: unsatisfactory results to the patient and /or the
physician. All adverse effects were checked during study.High resolution digital photographs
were taken for lesions of all patients using identical camera folder setting before starting
and one-month post treatment. Clinical improvement was evaluated by physicians through
comparing photographs. The criteria for evaluations using a quartile grading scale was: 0=no
improvement. 1=mild (percent improvement, less than 25%), 2=moderate (percent improvement
25-49%), 3=good (percent improvement 50-74%), 4=excellent (percent improvement more than
75%). In addition, a patient satisfaction score was rated using the following scale, A. not
satisfied, B. somewhat satisfied, C. highly satisfied.
Skin scrapes were taken from each group before and after treatment. All skin scrapes were
routinely processed by potassium hydroxide 20% to be examined for presence of fungal
elements. A built-in camera and a light microscope were used to photograph and examine the
sectioned skin areas.
IBM SPSS® ( International business machine statistical Package for the Social Sciences
(version 22, USA) was utilised for data analysis. The acceptability of the tested
formulations was assessed using the chi-square test, P ≤ 0.05 was considered statistically
significant. All the results were presented as the mean ± standard deviation (SD).
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