AZOLES ON RECALCITRANT CUTANEOUS DERMATOPHYTOSIS IN A TERITARY CARE HOSPITAL

Dr. Gouramma Huggi, Dr. Challagundla Sreelekha*, Dr. Kallappa C Herakal and Dr. Naganaboyina Srivani

ABSTRACT

Background: There is an increasing number of recalcitrant dermatophytosis cases in recent years. The standard treatment dosimetry is no longer effective in achieving clearance and results in high failure rate whereas combination therapy is a well-established concept in the treatment of recalcitrant dermatophytosis. Objective: To evaluate the efficacy and safety of oral Itraconazole and pulse fluconazole combination therapy along with topical ciclopirox olamine in the management of dermatophytosis. Methods: 200 Clinically diagnosed and KOH positive patients of tinea corporis/cruris were taken into our study and given itraconazole 200mg for 3 weeks and fluconazole 150mg pulse twice a week for 6 weeks along with topical antifungal once daily for 6 weeks. Patients were followed up at 3, 6, and 9 weeks. Adverse effects were noted at the end of therapy. Results: Cure rate of 90% is noted after 3 weeks of treatment, 93% at the end of 4th week of treatment and a maximum cure rate of 95% was achieved by 6th week, however recurrence of 2 patients was observed at 9th week follow up. Adverse affects were mild and patients were adherent with the study. Conclusions: The combination of systemic Itraconazole and fluconazole therapy may be an effective and safe therapeutic strategy and comparatively more effective than monotherapy in the management of dermatophytosis.

Keywords: Dermatophytosis • Itraconazole • Fluconazole • Ciclopirox olamine.