DOI: 10.36347/sjams.2018.v06i04.012

Pages: 1443-1451

Fungal infections are quite common in tropical and subtropical region. Many treatment modalities are available to treat superficial fungal infections, but with increasing number of recurrent/recalcitrant cases of tinea emerging these days, and lack of standard updated guidelines of treatment, new and effective therapy is needed to manage these cases. So this study is an attempt to find some effective therapy to manage these cases by conducting a comparative study to see the effect of double dose terbinafine, terbinafine used for double duration, and combination of terbinafine and isotretinoin in these recurrent/recalcitrant cases. A total of 90 patients with recurrent/recalcitrant tinea corporis/cruris were included. They were randomly divided into 3 equal groups of 30 patients each. In this study, comparison has been done between therapeutic efficacy and safety of oral Terbinafine 250 mg once daily for 6 weeks (double duration), vs oral Terbinafine 250 mg twice daily for 3 weeks (double dose), vs oral Terbinafine 250 mg once daily for 3 weeks plus oral isotretinoin 20 mg once daily for 6 weeks duration(combination of terbinafine and isotretinoin), in recalcitrant/ recurrent tinea corporis/ cruris. Follow-up was done at every 2 weekly intervals for a total duration of 12 weeks. When compared, highly significant results (P value=.000) were obtained when terbinafine was given for longer duration (6 weeks), whereas rates of relapse and incomplete response were more when terbinafine was given for shorter duration (3 weeks), either alone as given in Group B, or in combination with isotretinoin as given in Group C. Side effects in all the three groups were mild (nausea, chelitis, xerosis), and no patient required discontinuation of therapy.