Therapy: Resistant dermatophyte infection in India-clinico mycological study

Abstract

Background: There is a high frequency of recurrent, chronic, and therapy-resistant dermatophyte infections reported from India. Objectives: The study was carried out to identify the epidemiologic factors, clinical features, and causative agents associated with therapy-resistant tinea corporis. Subjects and Methods: Patients above 18 years of age, diagnosed by dermatologists, and received systemic therapy for at least 3 weeks with inadequate response or relapsed within 4 weeks of cessation of therapy were taken for the study. Demography, clinical features, and results of mycological examination were retrieved. Results: A total of 64 (33.7%) patients were included after screening 190 patients. There were 33 (51.6%) males and 31 (48.4%) females, and most patients (51, 79.7%) were young adults (18–45 years). Family history was obtained in 50 (78.1%) patients. Tinea cruris was associated in 50 (78. 1%) and tinea faciei in 15 (23.4%) of cases. Topical corticosteroids were used by 46 (71.87%) patients in the past. The past therapy with oral itraconazole (46 cases, 56.25%) was the most common to be used. Comorbidities were found in 7 (10.9%) patients. Trichophyton mentagrophytes in 55 cases (85. 9%) was the most common isolate followed by Trichophyton rubrum (7, 10.9%) cases associated with therapy-resistant tinea corporis. Conclusion: Therapeutic failure is alarmingly common in the current scenario of dermatophytosis in India. Failure is probably seen with all common isolates but the most common among T. mentagrophytes. Younger patients, high contagious nature, and concomitant tinea faciei may be associated with a higher risk of therapy resistance.