Alhamdi Dooha K, Alhamdi Khalil I
Department of Medicine, College of Medicine, University of Basrah, Iraq.
Indian J Dermatol. 2022 Sep-Oct;67(5):624. doi: 10.4103/ijd.ijd_332_22.
An increasing number of dermatophytosis is seen now in daily clinical practice, with unusual presentations, running a chronic recurrent course and seems to be more resistant to systemic and topical conventional treatments, which necessitate the use of other treatment options that help to cure these challenging clinical conditions such as isotretinoin along with itraconazole.
This is a prospective randomised open-label therapeutic comparative clinical trial to assess the efficacy and safety of low-dose isotretinoin along with itraconazole to treat and reduce the recurrence of this distressing chronic recurrent dermatophytosis.
Eighty-one patients with chronic recurrent dermatophytosis with positive mycological examination were recruited, all of them received itraconazole for 7 days per month for 2 consecutive months duration; half of them were randomly chosen to receive low-dose isotretinoin every other day for 2 months in addition to itraconazole. All patients were followed up at monthly intervals for 6 months.
The patients who received isotretinoin along with itraconazole showed earlier and complete clearance in 97.5% with a significantly low recurrence rate (12.8%) in comparison with those who received itraconazole alone where the cure rate was relatively slower reported in 53.7% of the patients with a relapse rate of 68.1% with no significant side effects.
Low-dose isotretinoin with itraconazole seems to be safe, effective and promising choice in the treatment of chronic recurrent dermatophytosis as it induced earlier complete cure with a significant reduction of recurrence rate.
在日常临床实践中，皮肤癣菌病的病例越来越多，其表现异常，病程呈慢性复发性，并且似乎对全身和局部的传统治疗更具抗性，这就需要使用其他治疗方案来治愈这些具有挑战性的临床病症，如异维A酸联合伊曲康唑。
这是一项前瞻性随机开放标签治疗性对比临床试验，旨在评估低剂量异维A酸联合伊曲康唑治疗并降低这种令人苦恼的慢性复发性皮肤癣菌病复发率的疗效和安全性。
招募了81例真菌学检查呈阳性的慢性复发性皮肤癣菌病患者，所有患者均连续2个月每月接受7天的伊曲康唑治疗；其中一半患者被随机选择除伊曲康唑外，每隔一天接受2个月的低剂量异维A酸治疗。所有患者每月随访1次，共随访6个月。
与仅接受伊曲康唑治疗的患者相比，接受异维A酸联合伊曲康唑治疗的患者中有97.5%的患者更早且完全清除，复发率显著较低（12.8%），而仅接受伊曲康唑治疗的患者中53.7%的患者治愈率相对较慢，复发率为68.1%，且无明显副作用。
低剂量异维A酸联合伊曲康唑似乎是治疗慢性复发性皮肤癣菌病的安全、有效且有前景的选择，因为它能更早地实现完全治愈，并显著降低复发率。
