Ketoconazole: a review of a workhorse antifungal molecule with a focus on new foam and gel formulations.

Topical ketoconazole, an imidazole, has been a mainstay of treatment for fungal infections and seborrheic dermatitis. Ketoconazole interferes with the fungal synthesis of ergosterol, a constituent of cell membranes, and has other antifungal effects. Shampoo, cream and oral formulations of ketoconazole have been available for many years. Recently, new foam and gel formulations of ketoconazole have been brought to market for the treatment of seborrheic dermatitis, which are effective against superficial fungal and yeast infections. The foam and gel formulations are likely to lead to a renascence of use of topical ketocona- zole for the treatment of skin disease, as patient preference and compliance might be augmented with such vehicles.