Background: There is an increase in the frequency of resistant and recurrent dermatophyte infections in India. We undertook a study to isolate the organisms in different clinical presentations and to study their sensitivity to clotrimazole, miconazole, fluconazole, and griseofulvin. Aims: The aim of this article was to study the clinico-mycological pattern of dermatophytes and their in-vitro sensitivity to commonly used antifungals. Objectives: The objectives were as follows: (1) to study the clinico-mycological patterns of dermatophytosis and (2) to study the in-vitro sensitivity patterns of culture isolates to clotrimazole, miconazole, fluconazole, and griseofulvin. Materials and Methods: A total number of 48 patients were included in the study. The study period was from August 2019 to February 2021. Skin scrapings and nail clippings were inoculated in Sabouraud dextrose agar. Isolates were identified based on gross colony characteristics and microscopic morphology of their micro- and macroconidia and accessory structures. The isolates were then transferred to sterile distilled water in vials and stored. The clinical isolates stored in the stock solution were subcultured on to Potato dextrose agar. Then, the antifungal disks and Griseofulvin E strip were applied on to the plates. The zones of inhibition around the disks were measured and recorded. In the case of E strip, the minimum inhibitory concentration value is read from the scale in terms of µg/mL, where the ellipse edge intersects the strip. Results: The total number of cases included were 48. Commonest clinical presentation was co-occurrence of Tinea cruris and corporis (33%). Trichophyton mentagrophytes was isolated in 56% of cases. Isolates showed highest sensitivity to clotrimazole (87.5%) followed by miconazole (60.4%). Only 8.3% were sensitive to fluconazole and 37.5% were sensitive to griseofulvin. Conclusion: T. mentagrophytes is the causative organism in significant numbers of dermatophytic infections. Though broth dilution is the standard method for sensitivity assay of dermatophytes, disk diffusion method could become a more simple alternative.

No abstract

Background: Recurrent or resistant warts may be due to defective cell-mediated immune response. Immunotherapy is directed at manipulating the immune system to achieve an anti-human papillomavirus immune reaction. Purpose: Our study compared the safety and efficacy of intralesional measles/mumps/rubella (MMR) vaccine to intralesional Vitamin D3 injection in recurrent warts. Methods: Sixty-six patients were divided into two groups of 33 each. In Group A and B, patients were injected with 0.5 ml of Vitamin D3 and 0.5 ml of MMR vaccine, respectively, intralesionally into the base of the largest wart every 2 weeks until complete clearance or for a maximum of 4 doses. The patients were evaluated for clinical improvement and any adverse effects. Results: Complete clearance of warts was noted in 52% (17) in Group A and in 70% (23) in Group B. Excellent to complete response was noted in 82% (27) in Group A and in 91% (30) in Group B. The clinical improvement noted with intralesional MMR vaccine was not statistically different than with intralesional Vitamin D3 (P > 0.05). Conclusion: Intralesional MMR and Vitamin D3 are promising options for recurrent warts.

Background: Cutaneous warts cause immense an burden to patients as well as physicians. Although most resolve spontaneously within two years, treatment is sought for pain alleviating and cosmetic reasons. Various modalities of treatment are known. The destructive methods are unsuitable for multiple warts and are associated with chances of recurrence, scarring, and pain. In contrast, immunotherapy boosts the host immune response against the virus and helps in clearance, even in distant warts, without scars or physical change. This study was undertaken to assess the efficacy of intralesional MMR vaccine in multiple recurrent common warts. Materials and Methods: Sixty-six patients with recurrent common warts were divided equally into two groups. In group one, 0.5 mL of the MMR vaccine and, in group two, 0.5 mL of normal saline were injected intralesionally into the base of the largest wart. The sessions were repeated once in two weeks for a maximum of four sessions. The patients were followed up for twelve months to detect recurrences. Results: Complete clearance of warts was noted in 75.76% (n = 25) of the patients in the study group, whereas, in the control group, 78.79% (n = 26) patients showed no response. The result was statistically significant (p < 0.01). Conclusion: Intralesional MMR is a safe and effective treatment option for recurrent common warts with minimal side effects. Key words: viral warts; intralesional MMR vaccine; immunotherapy