The role of topical tacrolimus in adherence to antifungal therapy in recalcitrant tinea incognito: a preliminary non randomised controlled study
DOI:
https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20190242Keywords:
Recalcitrant tinea incognito, Adherence, Topical tacrolimusAbstract
Background: The dropout of outpatients on antifungal therapy for recalcitrant tinea incognito is attributable to the flare on withdrawal of topical corticosteroids and the virulence of pathogens. The objective of the study was to evaluate the role of topical tacrolimus in adherence to antifungal therapy in recalcitrant tinea incognito.
Methods: 28 cases of topical corticosteroid induced tinea incognito of more than 6 months duration were enrolled and topical and systemic antifungal therapy instituted for 8 weeks. Topical tacrolimus was also instituted in the test cohort. The end point for resolution was the absence of raised margins, erythema, induration and scaling.
Results: 17 patients were male while 11 were female and their age ranged from 16-45 years (mean 26.5). Two patients were from upper-middle; 5 from lower-middle and 21 from upper-lower socioeconomic class. Their occupations included shop assistants, security guards, drivers and labourers and the duration of illness ranged from 7-36 months. Topical corticosteroids were obtained on prescription by 5 and over the counter by 23 patients. Out of the test cohort of 14, all lesions had resolved in 10 patients who had adhered to therapy and were reviewed at the end of 8 and 10 weeks. While 5 reported burning on application of tacrolimus 1 developed folliculitis. Out of the control cohort of 14, though 5 had adhered to therapy all lesions had resolved only in 3 patients at the end of 8 and 10 weeks.
Conclusions: Topical tacrolimus facilitates adherence to antifungal therapy in recalcitrant tinea incognito.
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References
Ive FA, Marks R. Tinea incognito. Br Med J. 1968;3:149-52.
Scorzoni L, de Paula E, Silva AC, Marcos CM, Assato PA1, de Melo WC, et al. Antifungal therapy: New Advances in the Understanding and Treatment of Mycosis. Front Microbiol. 2017;8:36.
Lin AN. Topical calcineurin inhibitors. In: Wolverton SE. Comprehensive dermatologic drug therapy 3rd ed. Edinburg: Saunders. 2013: 535-542.
Sharma R. Revised Kuppuswamy’s Socioeconomic Status Scale: Explained and Updated. Indian Pediatric. 2017;54(10):867-70.
Bishnoi A, Vinay K, Dogra S. Emergence of recurrent dermatophytosis in India. The Lancet Infectious Diseases. 2018;18(3):250-1.
Sardana K, Kaur R, Arora P, Goyal R, Ghunawat S. Is Antifungal Resistance a Cause for Treatment Failure in Dermatophytosis: A Study Focused on Tinea Corporis and Cruris from a Tertiary Centre? Indian Dermatol Online J. 2018;9(2):90-5.
Berth-Jones J. Principles of topical therapy. In: Griffiths CEM, Barker J, Bleiker T, Chalmers R, Creamer D, editors. Rook's Textbook of Dermatology. 9th ed. West Sussex: John Wiley & Sons, Ltd; 2016;18.1-39.
Steinbach WJ, Cramer RA Jr, Perfect BZ. Calcineurin controls growth, morphology, and pathogenicity in Aspergillus fumigatus. Eukaryot Cell. 2006;5(7):1091-103.
Juvvadi PR, Lee SC, Heitman J, Steinbach WJ. Calcineurin in fungal virulence and drug resistance: Prospects for harnessing targeted inhibition of calcineurin for an antifungal therapeutic approach. Virulence. 2017;8(2):186-97.
Liu S, Hou Y, Liu W, Lu C, Wang W, Sun S. Components of the calcium-calcineurin signalling pathway in fungal cells and their potential as antifungal targets. Eukaryot Cell. 2015;14(4):324-34.
Ozawa H, Okabayashi K, Kano R, Watanabe S, Hasegawa A. Antifungal Activities of the Combination of Tacrolimus and Itraconazole Against Trichophyton mentagrophytes. J Vet Med Sci. 2005;67(6):629-30.
Siddaiah N, Erickson Q, Miller G, Elston DM. Tacrolimus-induced tinea incognito. Cutis. 2004;73(4):237-8.
Crawford KM, Bostrum P, Russ B, Boyd J. Pimecrolimus-induced tinea incognito. Skinmed. 2004;3(6):352-3.
Rallis E, Koumantaki-Mathioudaki E. Pimecrolimus induced tinea incognito masquerading as interdiginous psoriasis. Mycoses. 2008;51(1):71-3.
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