Sir, Atopic dermatitis (AD) is a skin disease with complex genetic background which is chronic and pruritic inflammatory in nature with lifetime prevalence of 20%. [1] Topical corticosteroids (TCS) remain mainstay in treatment in spite of availability of multiple treatment options. [2] TCS are a class of hydrocortisone derivatives with variable potency and having anti-inflammatory as well as anti-pruritic properties but with the side effects profile. [3] In some clinical settings, while least potent corticosteroids may be sufficient, but same medication may not be effective in long-term management. [4] In such situation, mid-to high-potent TCS are favored. Mometasone furoate 0.1% (MF) and fluticasone propionate 0.005% (FP) creams are the two most commonly prescribed TCS, either as once daily (OD) or twice daily (BD) in the management of AD, respectively. Due to dearth of comparative data between these two drugs, this retrospective study was aimed to compare clinical assessment in the treatment of AD. A retrospective data analysis was done at 186 dermatology clinics across India after obtaining ethics committee approval (Suraksha Ethics Committee Regd No. ECR/644/Inst/ MH/2014/RR-20 Dated August 18, 2021). The data charts were identified by creating a list of patients (age ≥2 years) prescribed either MF or FP cream at all clinics, using the medical record database. Patients with incomplete data were excluded from the study. Effectiveness was assessed by Atopic Dermatitis Severity Index (ADSI) [5] and Investigator Global Assessment (IGA). ADSI (range, 0-15) consists of the sum of the scores for all symptoms such as erythema, pruritus, excoriation, exudation, and lichenification, with scoring on a 4-point scale (range, 0-3). IGA is graded on a 4-point scale (0 being clearance of the signs and symptoms and 4 beingThis is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

<p class="abstract"><strong>Background:</strong> The current scenario of dermatophytosis is alarming, despite the availability of multiple antifungal agents the management of dermatophytosis is still challenging. Hence there is a need for a different antifungal with a novel mechanism of action for the management of dermatophytosis.</p><p class="abstract"><strong>Methods: </strong>It was retrospective cohort study where in record of patients with dermatophytosis who were candidates for topical therapy only were analysed. All the patients were treated with Ciclopirox olamine 1% twice daily for 6 weeks. The efficacy end points were complete cure rate, mycological cure rate and clinical cure rate.</p><p class="abstract"><strong>Results: </strong>613 patients were included in the final analysis. At the end of study period the complete, mycological and clinical cure rates were 73.89%, 75.37% and 77.65% respectively. Out of 613 patients included 528 patients showed treatment failure to previous topical antifungal agents while 84 patients were treatment naïve. In treatment failure patients the complete, mycological and clinical cure rates were 72.15%, 73.48, and 75.56% respectively. In treatment naïve patients the complete, mycological and clinical cure rates were 84.70%, 87.05% and 90.58% respectively. 5.70% reported adverse events. The most common adverse event was pruritus followed erythema, dryness and rash.</p><p><strong>Conclusions: </strong>Results of this study proves that ciclopirox is efficacious and safe in the management of dermatophytosis. This study also proves that ciclopirox is useful in those patients who failed to respond to other topical antifungal agents. </p>

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