Annals of Medical and Surgical Dermatology

ABSTRACT

Background: Few researchers believed that the association of atopic dermatitis may alter the treatment outcome in dermatophytosis patients due to the shift in immunity to ward Th2 cytokines. However, there is a paucity of studies that analyzed the clinical and mycological cure rate at the end of 4 weeks of antifungal therapy (itraconazole and luliconazole cream) in dermatophytosis with associated atopic dermatitis.
Method: A total of 246 patients of dermatophytosis with associated atopic dermatitis and positive mycological tests (KOH and/or fungal culture) were enrolled to receive oral itraconazole 100mg twice daily and luliconazole 1% cream once daily application for 4 weeks. Patients were assessed for clinical cure at the end of therapy. Patients who did not achieve clinical cure were subjected to mycological tests (KOH& fungal culture) for identifying fungal infection.
Results: Eighteen (n=18) patients dropped out. At the end of the study, 228 patients were analyzed clinically. 43 (18.85%) patients achieved clinical cure. 185 (81.1%) patients who did not achieve clinical cure were subjected to fungal test therapy (KOH and fungal culture), of which 23 (12.43%) patients were positive for the fungus. Atopic dermatitis and diabetes were the frequently observed risk factors.
Drawback: An anti-fungal susceptibility test was not done.
Conclusion: In the present study, the proportion of patients showing clinical cure was low in dermatophytosis with associated atopic dermatitis. The patients who did not achieve clinical cure were composed of fungal positive in mycological tests, and there were around one to seven cases. The present study's low clinical cure ratewas possibly associated with atopic dermatitis, complicated fungal infection (prolonged disease course), and development of dermatosis unrelated to fungus (post-traumatic eczema).

Article History

KEYWORDS

1. Dermatophytosis
2. Tinea
3. Atopic dermatitis
4. Clinical cure
5. No cure
6. Dermatosis unrelated fungus
7. Treatment outcome