EFFICACY OF ANTIFUNGAL TREATMENT IN THE CLINICOMYCOLOGICAL CURE OF T. CORPORIS/T. CRURIS

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EFFICACY OF ANTIFUNGAL TREATMENT IN THE CLINICOMYCOLOGICAL CURE OF T. CORPORIS/T. CRURIS

Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 66

Abstract

BACKGROUND Dermatophytes are among the common fungal agents causing superficial skin infections worldwide. They affect about 20-25% of the world population and the causative agents of these infections vary from place to place. The present study was aimed at finding out the clinicomycological pattern of dermatophytosis, aetiological agents, comparing the clinical diagnosis with laboratory investigations and the clinicomycological cure following treatment. Terbinafine is well tolerated on topical administration and has low potential for drug interactions. In clinical trials, mycological and overall efficacy rate of topical terbinafine is around 80% and with an intermittent pulse dose therapy, cure rate of around 90% has been reported. MATERIALS AND METHODS This was a case series study of 50 patients. Clinical specimens like skin scraping were collected under aseptic precautions and sent to laboratory. All specimens were subjected to direct microscopy for fungal elements in 10% KOH and only KOH positive cases were included in the study. Culture was done in Sabouraud’s dextrose agar with chloramphenicol and cycloheximide and incubated at 260C and 370C separately. The colony morphology was identified by microscopy and confirmation of morphology was done by slide culture. All patients were treated with 1% topical terbinafine cream, twice daily for 4 weeks. KOH mount was repeated posttreatment and those patients who were not clinically and mycologically cured were treated with oral terbinafine for two weeks and topical terbinafine for another 4 weeks. RESULTS Out of 50 patients, maximum were seen in the age group of 18-27 years (32%). All 50 samples were positive by microscopic examination, out of which 48% were positive by culture. Trichophyton rubrum (54.16%) was the commonest isolate followed by T. mentagrophytes (33.33%), M. gypseum (4.16%) and M. audouinii (4.16%). 90% of patients had clinical cure (absence of visible erythema and scaling) after treatment with topical terbinafine for 4 weeks. The remaining patients were treated with oral terbinafine for two weeks and topical cream for another 4 weeks. During follow-up after 8 weeks, KOH mount was negative for all patients except one patient who was KOH and culture positive with same fungal isolate. CONCLUSION This study highlights a common problem in many areas of the world and suggests that further measures regarding public health and personal hygiene must be undertaken in order to reduce the risk of dermatophytosis. Also, a short duration of topical terbinafine along with systemic terbinafine, if required is very effective in the treatment of T. corporis/T. cruris. The endpoint of treatment is the clinical and mycological resolution.

Authors and Affiliations

Sajitha K, Carol Z. Fernandes

Keywords

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EP ID EP231885
DOI 10.14260/Jemds/2017/1032
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