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
Related Articles
- EP ID EP231885
- DOI 10.14260/Jemds/2017/1032
- Views 107
- Downloads 0
A CLINICOPATHOLOGICAL STUDY TO ANALYSE THE IMPORTANCE OF HISTOPATHOLOGICAL EXAMINATION IN DIAGNOSIS OF EXCISED CONJUNCTIVAL LESIONS
BACKGROUND Squamous papilloma is a benign tumor that originates from human papillomavirus infection of conjunctiva. This tumor can occur in children and adults. It has a pink fibrovascular frond of tissue arranged in a s...
APPROACH TO THROMBOCYTOPENIA- A CLINICOPATHOLOGICAL STUDY
BACKGROUND Thrombocytopenia is defined as decreased number of platelets below 1.0 lakh/μL1and it may be due to one of four causes: Decreased production, increased destruction, bone marrow failure or splenic sequestration...
ROLE OF FUNDUS FLUORESCEIN ANGIOGRAPHY IN EVALUATION OF RETINAL DISORDERS
BACKGROUND Retinal disorders are the leading cause of legal blindness in the age group of 20 to 65 years. Approximately 18 million people in India have severely impaired vision due to retinal diseases. It has been nearly...
AN ANALYSIS OF TWENTY FIVE CASES OF RANULA
BACKGROUND Ranula which are cystic lesions seen on the floor of the mouth are slow growing masses, which over a period of time can reach huge size. Though not malignant they usually cause pressure effects and this is the...
MACRODACTYLY WITH POLYSYNDACTYLY OF DISTAL PHALANX OF LEFT SECOND TOE – A RARE CASE REPORT AND ITS EMBRYOLOGICAL REVIEW’
Polydactyly is one of the common congenital anomaly. It occurs in many forms, ranging from varying degrees of mere splitting to complete duplication. It belongs to the category of duplication. The extra digit c...