The great Indian epidemic of superficial dermatophytosis: An appraisal

Verma, Shyam; Madhu, R

doi:10.4103/ijd.ijd_206_17

Cited by 186 publications

(8 citation statements)

References 31 publications

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“…In clinical practice, fixed-drug combinations (FDCs) containing corticosteroids alongside antifungal agents are also widely used. While corticosteroids offer rapid symptom relief by mitigating local inflammatory reactions, their inclusion may promote improper self-medication [ 18 , 19 , 20 ]. Incorrect and uncontrolled use of FDCs and topical antifungals may contribute to the emergence and spread of multidrug-resistant dermatophytosis [ 21 , 22 ].…”

Section: Treatment Of Dermatophytosis and Emergence Of Antifungal Res...mentioning

confidence: 99%

Trichophyton indotineae, an Emerging Drug-Resistant Dermatophyte: A Review of the Treatment Options

Sonego,

Corio,

Mazzoletti

et al. 2024

JCM

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Background: Dermatophytosis is a prevalent superficial infection caused by filamentous fungi, primarily affecting the skin and/or its appendages. In recent years, there has been a notable increase in mycotic strains resistant to standard antifungal therapies, including Trichophyton indotineae, a dermatophyte of the Trichophyton mentagrophytes complex. This review aims to provide a comprehensive overview of the treatment options for T. indotineae, elucidating their effectiveness in managing this challenging mycotic infection. Methods: For this review, a search was conducted in the PubMed, Scopus, Web of Science, Embase, and Google Scholar databases, encompassing all published data until March 2024. English-language articles detailing therapy outcomes for patients confirmed to be affected by T. indotineae, identified through molecular analysis, were included. Results: Itraconazole was shown to be a good therapeutic choice, particularly when administered at a dosage of 200 mg/day for 1–12 weeks. Voriconazole was also demonstrated to be effective, while terbinafine exhibited a reduced response rate. Griseofulvin and fluconazole, on the other hand, were found to be ineffective. Although topical treatments were mostly ineffective when used alone, they showed promising results when used in combination with systemic therapy. Mutational status was associated with different profiles of treatment response, suggesting the need for a more tailored approach. Conclusions: When managing T. indotineae infections, it is necessary to optimize therapy to mitigate resistances and relapse. Combining in vitro antifungal susceptibility testing with mutational analysis could be a promising strategy in refining treatment selection.

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Section: Treatment Of Dermatophytosis and Emergence Of Antifungal Res...mentioning

confidence: 99%

Trichophyton indotineae, an Emerging Drug-Resistant Dermatophyte: A Review of the Treatment Options

Sonego,

Corio,

Mazzoletti

et al. 2024

JCM

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“…Topical steroids suppress the normal immune response and act quickly to improve a patient’s symptoms but do little to eradicate the infection even when combined with an antifungal due to the steroid’s high potency. Without education and regulation, patients may also be applying these potent steroids for months or even years [ 2 ] with an underlying fungal skin infection. Consequently, fungal skin infection rates are high, have an unusual clinical presentation (making diagnosis more difficult), and are conducive to developing resistance [ 2 ].…”

Section: Main Bodymentioning

confidence: 99%

“…Without education and regulation, patients may also be applying these potent steroids for months or even years [ 2 ] with an underlying fungal skin infection. Consequently, fungal skin infection rates are high, have an unusual clinical presentation (making diagnosis more difficult), and are conducive to developing resistance [ 2 ].…”

Section: Main Bodymentioning

confidence: 99%

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Dermatophyte resistance – on the rise

Bristow,

Joshi

2023

Journal of Foot and Ankle Research

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Dermatophytes are group of filamentous fungi which have adapted to living on the skin of humans and other animals. In the last decade, reports have emerged from Asia of new dermatophyte strains showing resistance to the commonly used antifungal agent terbinafine and others. The spread of these resistant strains has been noted in many other countries globally. Little is known about the mechanisms or management of this emerging problem. Urgent research and changes to current practice are required if the spread of the infection is to be contained and managed effectively.

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“…Infections with dermatophytes have increased in India during the last several years [ 1 ]. The disease's appearance, severity, responsiveness to therapy, and recurrence rate have all changed in tandem with its rising prevalence [ 2 ]. According to the literature, the disease's evolving pattern and its reaction to current treatments may be caused by the shift to Trichophyton mentagrophytes as the primary pathogenic organism or perhaps by terbinafine resistance [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Amorolfine Lotion 0.25% w/v Compared to Amorolfine Cream 0.25% w/w in Patients With Superficial Fungal Infections of the Skin: A Multi-center, Randomized, Open-Label, Active-Controlled, Non-inferiority Phase III Clinical Trial

Rao,

Siddananjappa,

Sidana

et al. 2024

Cureus

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Background: Dermatophytosis, a major cause of superficial fungal infections, requires topical and systemic antifungals. Amorolfine, a morpholine derivative, is a new topical antifungal available in cream and lotion formulations.Objective: To evaluate the efficacy and safety of amorolfine lotion 0.25% compared to amorolfine cream 0.25% in patients with dermatophytosis.Methods: A multi-center randomized, two-arm, active-controlled, parallel, non-inferiority phase III clinical trial involving 284 dermatophytosis patients was conducted, with the test arm using amorolfine lotion and the reference arm using amorolfine cream. The study drugs were applied once daily in the evening for four weeks and patients were followed up for another two weeks. The primary endpoint was clinical cure, while secondary endpoints included mycological cure, composite cure, global efficacy assessment, and posttreatment relapse. Safety and tolerability were assessed.Results: Amongst the enrolled patients, 69.9% and 68.1% of patients had tinea corporis, while 30.1% and 31.9% had tinea cruris. The majority of patients in both groups (99.3% test and 97% reference) achieved a clinical cure at the end of treatment. Mycological cure was achieved by 98.6% and 96.3% respectively. A composite cure was achieved by 98.6% in the test arm versus 96.3% in the reference arm. A total of two AEs were reported in two (1.4%) patients in the test group and three AEs were reported in three (2.1%) patients in the reference group, all of the AEs were mild and resolved within three days without supportive medication. No severe adverse effects were reported in any of the study subjects.Conclusion: Amorolfine lotion 0.25% w/v showed a non-inferior clinical, mycological, and composite cure in dermatophytosis patients, was well-tolerated, and had a similar safety profile to amorolfine cream 0.25% w/w.

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The great Indian epidemic of superficial dermatophytosis: An appraisal

Cited by 186 publications

References 31 publications

Trichophyton indotineae, an Emerging Drug-Resistant Dermatophyte: A Review of the Treatment Options

Trichophyton indotineae, an Emerging Drug-Resistant Dermatophyte: A Review of the Treatment Options

Dermatophyte resistance – on the rise

Efficacy and Safety of Amorolfine Lotion 0.25% w/v Compared to Amorolfine Cream 0.25% w/w in Patients With Superficial Fungal Infections of the Skin: A Multi-center, Randomized, Open-Label, Active-Controlled, Non-inferiority Phase III Clinical Trial

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