Baveja Sukriti, Vashisht Deepak, Kothari Rohit, Venugopal Ruby, Kumar Joshi Rajneesh
Deputy Commandant, OTC, AMC (Centre & College), Lucknow, India.
Professor (Dermatology), Command Hospital, (Southern Command), Pune, India.
Med J Armed Forces India. 2023 Sep-Oct;79(5):526-530. doi: 10.1016/j.mjafi.2021.07.001. Epub 2021 Sep 23.
Current trend of rising drug-resistant dermatophyte infection is alarming and fretted by dermatologists. Dilemma prevails regarding use of the same or different class of antifungal agents topically and systemically. The aim was to study the efficacy of oral itraconazole 200 mg with 1% terbinafine cream versus oral itraconazole 200 mg with 2% sertaconazole cream in dermatophytosis.
This within-person open-label pilot study enrolled 50 patients with dermatophytosis. Two lesions of comparable size within each patient were randomly allotted to group A and B and treated with 2% sertaconazole and 1% terbinafine cream, respectively. Both groups received itraconazole 200 mg once daily for 4 weeks. The remaining lesions received 1% terbinafine cream. Response and adverse effects were assessed at 2 and 4 weeks. Reduction in erythema, scaling, pruritus and clinical, and mycological cure constituted efficacy outcomes.
The mean duration of lesions was 2.82 ± 1.35 months. Complete clinical cure was observed in 50% and 48%, whereas mycological cure was attained in 56% and 52% patients in groups A and B, respectively, after 4 weeks, which was statistically insignificant. Reduction in erythema, scaling, and pruritus after 4 weeks when compared between the two groups, was also statistically insignificant.
Same class of oral and topical antifungal agents has comparable efficacy with different classes of oral and topical antifungal agents in dermatophyte infection.
目前耐药皮肤癣菌感染不断上升的趋势令人担忧,皮肤科医生对此深感忧虑。在局部和全身使用同一类或不同类抗真菌药物方面存在两难困境。本研究旨在比较口服200毫克伊曲康唑联合1%特比萘芬乳膏与口服200毫克伊曲康唑联合2%舍他康唑乳膏治疗皮肤癣菌病的疗效。
本项自身开放标签的前瞻性研究纳入了50例皮肤癣菌病患者。将每位患者身上两个大小相当的皮损随机分为A组和B组,分别用2%舍他康唑乳膏和1%特比萘芬乳膏治疗。两组均每日口服一次200毫克伊曲康唑,共4周。其余皮损使用1%特比萘芬乳膏。在第2周和第4周评估疗效和不良反应。红斑、鳞屑、瘙痒的减轻以及临床和真菌学治愈均作为疗效指标。
皮损的平均病程为2.82±1.35个月。4周后,A组和B组分别有50%和48%的患者实现了完全临床治愈,而真菌学治愈率分别为56%和52%,差异无统计学意义。两组在4周后红斑、鳞屑和瘙痒减轻程度的比较,差异也无统计学意义。
在皮肤癣菌感染中,同一类口服和外用抗真菌药物与不同类口服和外用抗真菌药物的疗效相当。