Expert consensus on management of dermatophytosis in elderly patients, patients with comorbidities, and immunocompromised status: an Indian perspective

Authors

  • Jayakar Thomas J. T. Skin Care Centre, Chennai, Tamilnadu, India
  • Anchala Parthasaradhi Department of Dermatology, Maheshwara Medical College, Patan Cheru, Telangana, India
  • A. K. Bajaj Bajaj Skin Clinic, Panna Lal Road, George Town, Behind Company Bagh, Allahabad, Uttar Pradesh, India
  • Mukesh Girdhar Girdhar's Skin Clinic, Rishabh Tower Community Centre, Karkardooma, Delhi, India
  • Asok Ghoshal Asok Ghoshal, Nightingale Diagnostic Centre, Shakespeare Sarani, Kolkata, India
  • Rizwan Haq Skinmax Clinics 1st Floor Sahu Samaj Apartment, Sakkardara, Sakkardara Chowk, Nagpur, Maharashtra, India
  • Maleeka Sachdev Scf-6, Chandigarh Sector 18c, Opp Tagore Theatre, Chandigarh, Punjab, India
  • Anil Ganjoo Skinnovation Clinic B-11, Gujrawalan Town Part 1, Model Town, Delhi, India
  • Bikash R. Kar Department of DVL, IMS and SUM Hospital, Bhubaneswar, SOA deemed to be University, India

DOI:

https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20205613

Keywords:

Dermatophytosis, Treatment, Elderly, Comorbidity, Immunocompromised, Polypharmacy

Abstract

Dermatophytosis is a common fungal infection of skin contributing to increasing disease burden worldwide. Increasing age, presence of comorbid conditions and immunity have a profound impact on the manifestation of dermatophyte infections. Treatment of dermatophytosis includes monotherapy, combination therapy, or sequential therapy of antifungal drugs. However, specific patient populations such as the elderly, people with comorbid conditions, immunocompromised patients, etc. are subjected to inappropriate adverse events due to highly interacting host and drug factors. Thus, the management of dermatophytosis in special populations is a challenge, and it demands a change in the regular treatment plan. A group of Indian experts reviewed the evidence available on different antifungal agents for the management of dermatophytosis and provided their expert opinion on safe and effective management of the condition in special clinical scenarios. This article summarizes the consensus clinical viewpoint of the entire expert panel for a choice of the antifungal drug, factors to be assessed, and treatment considerations in special populations with dermatophytosis. The panel emphasized that complete knowledge of patient's clinical history, presence of comorbid conditions, and pharmacokinetic and pharmacodynamic characteristics of antifungal agents and associated potential drug interactions are essential for the successful management of dermatophytosis in these patients. Also, regular monitoring of drug toxicity is important during antifungal therapy in special population.

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Published

2020-12-24

Issue

Vol. 7 No. 1 (2021): January-February 2021

Section

Review Articles