Clioquinol
| Evidence Level: L4 | Predicted Indications: 10 |
Table of Contents
Clioquinol: From Tinea Infections to Cutaneous Candidiasis
One-Sentence Summary
Clioquinol is a topical halogenated hydroxyquinoline originally used for fungal skin infections such as tinea pedis, tinea corporis and groin dermatophytosis. The TxGNN model predicts it may be effective for cutaneous candidiasis, but there are currently no registered clinical trials and only 1 publication (a 1988 in vitro report on soap additives, not a clinical evaluation of clioquinol) linked to this prediction. This is a computational prediction with very limited supporting evidence.
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Tinea pedis, tinea corporis, tinea infection, dermatophytosis of groin and perianal area (from the knowledge graph; the Singapore licence records contain no indication text) |
| Predicted New Indication | Cutaneous candidiasis |
| TxGNN Prediction Score | 99.84% |
| Evidence Level | L4 |
| Singapore Market Status | ✓ Marketed |
| Number of Registrations | 4 |
| Recommended Decision | Hold |
Why is This Prediction Reasonable?
Currently, detailed mechanism of action data is not available. Based on known information, clioquinol is a halogenated hydroxyquinoline with metal-chelating (copper and zinc) antifungal and antibacterial activity. Its efficacy in superficial dermatophyte infections is the basis of its original use, and mechanistically it may be applicable to Candida infections of the skin.
Both dermatophytosis and cutaneous candidiasis are superficial fungal skin infections that are treated topically, which makes the extrapolation plausible. However, Candida is a yeast, not a dermatophyte, so activity cannot be assumed without direct data. The only linked paper (PMID 2978600, 1988) studied additives to toilet soaps against Candida albicans in vitro. Judging from its title and abstract, it is not a controlled clinical evaluation of clioquinol. The very high TxGNN score (0.998) is a computational output and not clinical evidence.
Clinical Trial Evidence
Currently no related clinical trials registered.
Literature Evidence
| PMID | Year | Type | Journal | Key Findings |
|---|---|---|---|---|
| 2978600 | 1988 | Other (occupational prevention report) | Przeglad dermatologiczny | In vitro study of toilet soap additives against C. albicans strains from patients; soap foam properties and heat resistance were also assessed. Not a controlled clinical study of clioquinol. |
Singapore Market Information
| Authorization Number | Product Name | Dosage Form | Approved Indication |
|---|---|---|---|
| SIN08790P | HYDRODERM-C CREAM 1% | Cream | Not stated in the data compiled for this report |
| SIN08795P | DERMANOL-C CREAM 0.1% | Cream | Not stated in the data compiled for this report |
| SIN08793P | DERMANOL-C CREAM 0.025% | Cream | Not stated in the data compiled for this report |
| SIN08796P | DERMANOL-C CREAM 0.05% | Cream | Not stated in the data compiled for this report |
All four are valid single-ingredient topical cream licences held by ICM Pharma Pte. Ltd.
Safety Considerations
No package insert warnings, contraindications or drug interaction data were available. Please refer to the package insert for safety information.
The following contraindication-related associations come from a knowledge graph, not from label text, and should be verified against the official label:
- Adrenocortical insufficiency and Addison disease
- Skin atrophy
- Telangiectasis, capillary disease and hereditary hemorrhagic telangiectasia
- Peripheral vascular disease, intermittent vascular claudication and peripheral arterial disease
Conclusion and Next Steps
Decision: Hold
Rationale: The prediction score is very high, but the only linked paper is an old in vitro report that does not evaluate clioquinol clinically, and no trials exist. Safety label data are also missing, so the prediction is not yet actionable.
To proceed, the following is needed:
- Package insert warnings and contraindications from the HSA (a blocking gap for safety screening)
- Mechanism of action data for clioquinol
- Direct evidence of clioquinol activity against Candida species (in vitro susceptibility, then controlled clinical studies in cutaneous candidiasis)
- Confirmation of the approved indication wording on the Singapore licences
Other Predicted Indications (Context)
Other predictions are mostly dermatophyte or related skin conditions. Closest to the approved use are superficial mycosis (L4; a 2021 preclinical study combining clioquinol with ciclopirox and terbinafine, PMID 33772895; Research Question) and tinea manuum (L5; Research Question). Pityriasis versicolor (L5) is also a Research Question. Deep or hair-associated infections (Majocchi granuloma, ectothrix and endothrix infections, scalp or beard dermatophytosis, tinea profunda) are unlikely to respond to topical therapy and remain on Hold. Granuloma annulare is a non-infectious condition with no clear rationale and may be an artifact of the model.
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.