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Introduction: Dermatophytosis is a common fungal infection caused by Trichophyton, Epidermophyton, Microsporum species. Combination of systemic and topical antifungal therapy is in vogue for all patients with dermatophytosis, except in cases of localised naïve Tinea. Recently, a rising prevalence of poor response to standard regimen of treatment has been noted. In this study, we tried to find out the benefits and adverse effects of systemic antifungal combination therapy in the treatment of tinea. Aim: To compare the efficacy of oral terbinafine with itraconazole or griseofulvin combination therapy in the management of dermatophytosis and to assess the adverse effects associated with these combination therapies. Materials and Methods: The present randomised clinical trial comprised of 60 patients with dermatophytosis who were divided into two groups. The study was conducted in the Department of Dermatology, Outpatient Department (OPD), Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India, from December 2020 to May 2021. Group I was treated with terbinafine 250 mg OD and itraconazole 200 mg OD and group II with terbinafine 250 mg OD with griseofulvin 250 mg BD for a period of four weeks and the patients were followed-up every two weeks with appropriate investigations. Outcome of the treatment was assessed at four weeks and eight weeks. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS) version 16.0. Descriptive analyses were performed to compare the baseline characteristics of the participants between the two study groups. Student t-test was applied to compare the mean values of quantitative variables. Chi-square test was used for analysing the categorical variables. A p-value of

Background: The incidence of recurrent tinea infections after oral terbinafine therapy is on the rise. Aim: This study aims to identify the appearance of incomplete cure and relapse after 2-week oral terbinafine therapy in tinea corporis and/or tinea cruris. Materials and Methods: A total of 100 consecutive patients clinically and mycologically diagnosed to have tinea corporis and/or tinea cruris were included in the study. The enrolled patients were administered oral terbinafine 250 mg once daily for 2 weeks. All clinically cured patients were then followed up for 12 weeks to look for any relapse/cure. Results: The common dermatophytes grown on culture were Trichophyton rubrum and Trichophyton tonsurans in 55% and 20% patients, respectively. At the end of 2-week oral terbinafine therapy, 30% patients showed a persistent disease on clinical examination while 35% patients showed a persistent positive fungal culture (persisters) at this time. These culture positive patients included all the clinically positive cases. Rest of the patients (65/100) demonstrated both clinical and mycological cure at this time (cured). Over the 12-week follow-up, clinical relapse was seen in 22 more patients (relapse) among those who had shown clinical and mycological cure at the end of terbinafine therapy. Thus, only 43% patients could achieve a long-term clinical and mycological cure after 2 weeks of oral terbinafine treatment. Majority of the relapses (16/22) were seen after 8 weeks of completion of treatment. There was no statistically significant difference in the body surface area involvement or the causative organism involved between the cured, persister, or relapse groups. Conclusions: Incomplete mycological cure as well as relapse is very common after standard (2-week) terbinafine therapy in our patients of tinea cruris/corporis.

Background: Dermatophytoses are the superficial fungal infections of skin, hair, and nail. Butenafine is a benzylamine group of antifungal that inhibits the biosynthesis of ergosterol by blocking squalene epoxidase. Sertaconazole is a newer imidazole antifungal which inhibits the biosynthesis of ergosterol by inhibiting 14-a lanosterol demethylase. The study was done to compare a newer antifungal with a relatively older one. Aim: To compare the efficacy, safety and cost effectiveness of topical 2% sertaconazole cream and 1% butenafine in tinea infections of skin Materials and Methods: Patients were randomly allocated to two treatment groups. They were advised to apply the drug topically twice a day for one month on the lesions. They were followed up at an interval of 10 days. Clinical score and Global Evaluation Response were assessed at baseline and during each follow up. Results: A total 125 patients were recruited, out of them 111 completed the whole study. Median Sign and Symptom Score of tinea on the baseline was 9 [5,9] that was reduced to 0 [0,4] by 2% sertaconazole while it was 9 [6,9] in the butenafine group on the baseline that was reduced to 0 [0,6] at the end of the treatment. 98% and 90% of the patients got complete clearance of the lesions with butenafine and sertaconazole, respectively. Treatment with butenafine was more cost effective as compared to sertaconazole. Conclusion: 1% butenafine is more efficacious, cost effective, and equally safe as compared to 2% sertaconazole in the tinea infections of skin.