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Background: The most common superficial fungal infections are tinea corporis, tinea cruris, tinea capitis, tinea pedis, tinea unguium, and tinea facie and cutaneous Candida albicans infections such as oral thrush, oropharyngeal candidiasis, vaginal candidiasis, and onychomycosis. Aims and Objectives: (i) Analysis of prescription pattern of antifungal drugs and (ii) to study common adverse effects. Materials and Methods: A retrospective, observational study conducted in B. K. L. Walawalkar Hospital, Sawarde, Ratnagiri. A total of 993 case papers were analyzed after getting approval from the institutional ethics committee and permission from dermatology department. The frequency with percentage was used for the analysis of data. Results: In 993 patients with superficial fungal infections, 523 (52.7%) were males and 470 (47.3%) were females. Majority of patients were belonged to 21-40-year age group, i.e., 439 (44.2%) followed by 41-60 years, i.e., 244 (24.6%). Our study shows that the most common superficial fungal infections with single lesion were tinea corporis (22.3%), tinea cruris (14.6%), and pityriasis versicolor (13.9%). In Candida albicans, the most common infection was onychomycosis 14 (1.4%). The most common antifungal prescribed was luliconazole (20.84%) followed by itraconazole (20.58%). The most common route was topical route (68.26%). Combination of drugs was not prescribed. Different prescription indicators were that the average number of drugs prescribed per encounter was 3.4 and average number of drugs prescribed per encounter was 2.7. Conclusion: Most commonly prescribed newer antifungal was luliconazole. Next most commonly prescribed by oral route was itraconazole. In our study prescription pattern were rational approach in two points, they are no use of combination of drugs and many drugs were selected from essential medicinal list. [ABSTRACT FROM AUTHOR]

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 <0.05 was considered as significant. Results: Itraconazole containing group reported a better clinical cure rate than the griseofulvin containing group (p<0.05). Neither of the combination showed effectiveness against tinea infections pretreated with topical steroid containing formulations. Conclusion: Combination of terbinafine with itraconazole produce higher clinical cure rate as compared to the combination of terbinafine with griseofulvin; but the percentage of clinical cure rate is less as compared to published studies in the past. Neither of the combination of systemic antifungals has shown efficacy against tinea infections pretreated with topical steroid containing formulations. [ABSTRACT FROM AUTHOR]

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

This article looks at a case of fungal infections in three siblings, two of which were seen in dermatology, and their journey to diagnosis and management. [ABSTRACT FROM AUTHOR]

Dermatophytes infections, especially those affecting the keratinized tissues, are a major concern worldwide and are increasing on a global scale. Dermatophytosis is an infection of the skin, hair, and nails as a result of colonization of the Keratin layers in the body. The factors causing dermatomycosis are classified in three distorted genera, Epidermophyton, Microsporum, and Trichophyton. This study was aimed to isolate and identify Trichiphyton rubrum from different Tinea infection using morphological features including scanning electron microscope examination and to evaluate its sensitivity towards several antifungal drugs. Seventy-three Tinea infections specimens were included in this study. All the clinical specimens were cultured onto sabouraud dextrose agar plates and potato dextrose agar plates and identified using cultural and microscopic features. The positive specimens for Trichiphyton rubrum were tested for susceptibility towards different antifungal drugs. The results showed that from all the clinical specimens (73), included in this study 25 (34.2%) were positive for Trichiphyton rubrum. Tinea corporis was the most common clinical type of Trichiphyton rubrum infection with incidence of 9 (36%). All of the Trichiphyton rubrum isolates were sensitive to Nystatin (NS 100 IU), Amphotericin-B (AP 100 IU) and Itraconazole (IT 10µg), and resistant to Clotrimazole (CC 10µg), Ketoconazole (KT 10µg), and Fluconazole (FLC 10µg). In Conclusion Tinea corporis is the most dermatophytosis caused by Trichiphyton rubrum and Nystatin is the most effective antifungal drug towered it. [ABSTRACT FROM AUTHOR]

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.

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. [ABSTRACT FROM AUTHOR]

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‑α 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. [ABSTRACT FROM AUTHOR]

Dermatomycoses are contagious superficial fungal infections, which are highly prevalent in developed and developing countries. Caused by a range of Epidermophyton, Microsporum and Trichophyton species, dermatomycoses manifest on glabrous skin as ‘ringworm’, an annular scaly lesion with a variable inflammatory component. Itch is the chief subjective symptom, particularly in tinea cruris. Unless lesions are extensive or resistant to local therapy, dermatomycoses of glabrous skin are treated with topical antifungal agents, such as imidazoles and allylamines. Studies show, however, that the addition of a topical corticosteroid to imidazole therapy increases the bioavailability and prolongs the activity of the antimycotic, while rapidly reducing inflammatory symptoms. Travocort® is a combination of 1% isoconazole nitrate (ISN), a broad-spectrum imidazole with established antimicrobial activity and antimycotic efficacy, and 0.1% diflucortolone valerate (DFV), a potent topical corticosteroid with low systemic absorption and therefore a low risk of systemic glucocorticoid side-effects. In randomised, double-blind controlled clinical trials, Travocort® therapy showed a more rapid onset of action, faster relief of itch and other inflammatory symptoms, improved overall therapeutic benefits and better mycological cure rate during the first 2 weeks of treatment compared with ISN monotherapy. Travocort® is well tolerated and, because of prolonged ISN retention in the skin, provides antifungal protection against reinfection for some weeks after therapy. [ABSTRACT FROM AUTHOR]

This article refers to papulosquamous diseases that are seen in the elderly. Many of these diseases are complex to diagnose due to the fact that they are difficult to identify, because they may resemble a similar disorder, which can be misleading. The problem that is frequently seen with these diseases is that they are commonly misdiagnosed. In this article the authors include information that will help with identifying these diseases. The authors also provide important laboratory exams that can be performed and can help guide diagnosis, as well as differential diagnosis and treatment options. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The aim of this study is to compare the efficacy, safety and cost-effectiveness of topical Whitfield's ointment plus oral fluconazole with topical 1% butenafine in tinea infections of the skin. Materials and Methods: Patients were randomly allocated to the two treatment groups and advised to apply either agent topically twice-a-day for 4 weeks on the lesions and fluconazole (150 mg) was administered once a week for 4 weeks in the study group applying Whitfield's ointment. Patients were followed-up at an interval of 10 days for clinical score and global evaluation response was assessed at baseline and during each follow-up. Results: Out of 120 patients enrolled in the study 103 completed the study. Patients treated with Whitfield's ointment and oral fluconazole reduced mean sign and symptom score from 8.81 ± 0.82 to 0.18 ± 0.59 while butenafine treated patients reduced it from 8.88 ± 0.53 to 0.31 ± 0.67 at the end of the treatment. Nearly, 98% patients were completely cleared of the lesion on the 3rd follow-up with both treatments. Conclusion: Whitfield's ointment with oral fluconazole is as efficacious, safe and costeffective as compared with 1% butenafine in tinea infections of the skin. [ABSTRACT FROM AUTHOR]