Chaudhary Raju G, Rathod Santoshdev P, Jagati Ashish, Zankat Dhara, Brar Arwinder K, Mahadevia Bansri
Department of Dermatology, N.H.L. Medical College, Ahmedabad, Gujarat, India.
Indian Dermatol Online J. 2019 Mar-Apr;10(2):125-130. doi: 10.4103/idoj.IDOJ_353_18.
Antifungals are one of the most widely used drugs in dermatology practice for dermatophytosis. Oral antifungal therapy against superficial dermatophytosis is generally associated with a low incidence of adverse events in an immunocompetent population. However, lately, cutaneous adverse drugs reactions (CADRs) have been reported with varying incidence rates in the patients on oral antifungal therapy with many uncommon morphological patterns. The present, observational study was conducted over a period of 4 months to report the cases which presented with antifungal therapy-associated CADRs.
It was an observational, prospective study carried out at a tertiary care center in Western India over a period of 4 months. All patients diagnosed with superficial dermatophytic infections (clinically and fungal hyphae seen on 10% potassium hydroxide mount) started on oral antifungal therapy, presenting with cutaneous manifestation other than the primary dermatophytosis were included. The incidence of CADRs due to oral antifungal agents and the percentage of each clinical type of the CADR observed was calculated.
The incidence of CADRs due to antifungal drugs was 8.3 per 10,000 patients. In total, 35 cases were reported out of 4,208 cases of dermatophytosis. Terbinafine was the most common causative drug, accounting for nearly 83% of cases, followed by itraconazole for 14% cases, and griseofulvin for 2.8% of cases.
The role of systemic antifungals must not be overlooked in any patient with a CADR and should be reported as a trend indicator.
抗真菌药物是皮肤科治疗皮肤癣菌病最常用的药物之一。在免疫功能正常的人群中，口服抗真菌药物治疗浅表皮肤癣菌病通常不良事件发生率较低。然而，最近有报道称，接受口服抗真菌治疗的患者出现了皮肤药物不良反应（CADR），其发生率各不相同，且有许多不常见的形态学模式。本观察性研究历时4个月，旨在报告出现抗真菌治疗相关CADR的病例。
这是一项在印度西部一家三级医疗中心进行的为期4个月的观察性前瞻性研究。所有被诊断为浅表皮肤癣菌感染（临床诊断且在10%氢氧化钾涂片上可见真菌菌丝）并开始口服抗真菌治疗，出现原发性皮肤癣菌病以外皮肤表现的患者均被纳入研究。计算口服抗真菌药物导致的CADR发生率以及观察到的每种CADR临床类型的百分比。
抗真菌药物导致的CADR发生率为每10000名患者8.3例。在4208例皮肤癣菌病病例中，共报告了35例。特比萘芬是最常见的致病药物，占病例的近83%，其次是伊曲康唑，占14%，灰黄霉素占2.8%。
对于任何出现CADR的患者，全身用抗真菌药物的作用都不应被忽视，应将其作为一个趋势指标进行报告。
