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- DOI 10.18231/j.ijced.67329.1758875654
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CrossMark
A comparative study on efficacy of oral ultramicrosized griseofulvin and oral itraconazole on dermatophytic infection of skin
- Author Details:
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Amarjeet Singh
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Kshitij Saxena
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Riya Kalawat *
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Ketki .
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Bhavika Bansal
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Hansa Srivastava
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Nidhi Khatri
Amarjeet Singh
Kshitij Saxena
Riya Kalawat *
Bhavika Bansal
Introduction: Dermatophytosis is a common superficial fungal infection affecting keratinized tissues, with significant health and cosmetic impacts. Though itraconazole is widely used due to its broad-spectrum antifungal efficacy, its higher cost and adverse effects necessitate exploration of alternatives like ultramicrosized griseofulvin. This study aimed to compare the clinical efficacy, safety, and cost-effectiveness of oral itraconazole and oral ultramicrosized griseofulvin in the treatment of tinea corporis and tinea cruris.
Materials and Methods: A randomized controlled trial was conducted over 24 months at Era’s Lucknow Medical College & Hospital. A total of 243 patients with KOH-confirmed tinea corporis or tinea cruris were randomly allocated into two groups: Group A (n=121) received oral itraconazole 100 mg twice daily, and Group B (n=122) received oral ultramicrosized griseofulvin 500 mg twice daily for six weeks. Clinical, mycological, and symptomatic evaluations were performed at baseline and at 2, 4, 6, and 8 weeks. p-values <0.05 considered statistically significant.
Results: Both groups were comparable in baseline demographic and clinical characteristics. Among the 88 patients receiving itraconazole and 83 receiving ultramicrosized griseofulvin, recurrence rates were comparable. At 8 weeks, scaling resolution was significantly higher with Itraconazole (97.0% vs 76.9%), while erythema and pruritus showed similar improvement across groups. Recurrence rates and KOH negativity were comparable between groups. No adverse events necessitating treatment withdrawal were reported in either group.
Conclusion: Ultramicrosized griseofulvin is a safe, cost-effective, and clinically effective alternative to itraconazole for treating dermatophytosis, particularly in low-resource settings.
References
- Weitzman I, Summerbell RC. The dermatophytes. Clin Microbiol Rev. 1995;8(2):240–59.
- Jartarkar SR, Patil A, Goldust Y, Cockerell CJ, Schwartz RA, Grabbe R, et al. Pathogenesis, immunology and management of dermatophytosis. J Fungi (Basel). 2021;8(1):39.
- Dismukes WE, Pappas PG, Sobel JD. Clinical mycology. New York: Oxford University Press; 2003.
- Al-Janabi AA. Dermatophytosis: causes, clinical features, signs and treatment. J Sympt Signs. 2014;3(3):200–3.
- Bitew A. Dermatophytosis: prevalence of dermatophytes and non- dermatophyte fungi from patients attending Arsho Advanced Medical Laboratory, Addis Ababa, Ethiopia. Dermatol Res Pract. 2018;2018:8164757.
- Bontems O, Fratti M, Salamin K, Guenova E, Monod M. Epidemiology of dermatophytoses in Switzerland according to a survey of dermatophytes isolated in Lausanne between 2001 and
- J Fungi (Basel). 2020;6(2):95.
- Brasch J, Glaser R. Dynamic diversity of dermatophytes. Hautarzt. 2019;70(8):575–80.
- Ferguson L, Fuller LC. Spectrum and burden of dermatophytes in children. J Infect. 2017;74(Suppl 1):S54–60.
- Gandhi S, Patil S, Patil S, Badad A. Clinicoepidemiological study of dermatophyte infections in pediatric age group at a tertiary hospital in Karnataka. Indian J Paediatr Dermatol. 2019;20(1):52–
- Bhatia VK, Sharma PC. Epidemiological studies on dermatophytosis in human patients in Himachal Pradesh, India. Springerplus. 2014;3:134.
- Araya S, Abuye M, Negesso AE. Epidemiological characterization of dermatomycosis in Ethiopia. Clin Cosmet Investig Dermatol. 2021;14:83–9.
- Elsner P, Hartmann AA, Kohlbeck M. Dermatophytoses in Würzburg 1976–1985. Mykosen. 1987;30:584–8.
- Tietz HJ, Kunzelmann V, Schoenian G. Changes in the fungal spectrum of dermatomycoses. Mycoses. 1995;38(Suppl 1):33-39.
- Patro N, Panda M, Jena AK. The menace of superficial dermatophytosis on the quality of life of patients attending referral hospital in Eastern India: a cross-sectional observational study. Indian Dermatol Online J. 2019;10(3):262–6.
- Narang T, Bhattacharjee R, Singh S, Jha K, Kavita, Mahajan R, Dogra S. Quality of life and psychological morbidity in patients with superficial cutaneous dermatophytosis. Mycoses. 2019;62(8):680–5.
- Yee G, Al Aboud AM. Tinea corporis. [Updated 2021 Jan 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing;
- Available fro m: https://www.ncbi.nlm.nih.gov/books/NBK544360/
- De Beule K, Van Gestel J. Pharmacology of itraconazole. Drugs. 2001;61(Suppl 1):27–37.
- Kurn H, Wadhwa R. Itraconazole. [Updated 2023 Apr 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing;
- Available from: https://www.ncbi.nlm.nih.gov/books/NBK557874/
- Elewski B, Tavakkol A. Safety and tolerability of oral antifungal agents in the treatment of fungal nail disease: a proven reality. Ther Clin Risk Manag. 2005;1(4):299–306.
- Abraham AO, Panda PK. Itraconazole induced congestive heart failure: a case study. Curr Drug Saf. 2018;13(1):59-61.
- Gupta AK, Mays RR, Versteeg SG, Piraccini BM, Shear NH, Piguet V, et al. Tinea capitis in children: a systematic review of management. J Eur Acad Dermatol Venereol. 2018;32(12):2264–74.
- Lachapelle JM, De Doncker P, Tennstedt D, Cauwenbergh G, Janssen PA. Itraconazole compared with griseofulvin in the treatment of tinea corporis/cruris and tinea pedis/manuum: an interpretation of the clinical results of all completed double-blind studies with respect to the pharmacokinetic profile. Dermatology. 1992;184(1):45–50.
- Panagiotidou D, Kousidou T, Chaidemenos G, Karakatsanis G, Kalogeropoulou A, Teknetzis A, et al. A comparison of itraconazole and griseofulvin in the treatment of tinea corporis and tinea cruris: a double-blind study. J Int Med Res. 1992;20(5):392–400.
- López-Gómez S, Del Palacio A, Van Cutsem J, Cuétara MS, Iglesias L, Rodriguez-Noriega A. Itraconazole versus griseofulvin in the treatment of tinea capitis: a double-blind randomized study in children. Int J Dermatol. 1994;33(10):743–7.
- Ramesh A, Devasena S, Mathew D. Efficacy and safety of oral terbinafine with itraconazole or griseofulvin combination therapy in the management of dermatophytosis: a randomised clinical trial. J Clin Diagn Res. 2022;16(1):WC05–8.
- Acharya KM, Mukhopadhyay A, Thakur RK, Mehta T, Bhuptani N, Patel R. Itraconazole versus griseofulvin in the treatment of tinea corporis and tinea cruris. Indian J Dermatol Venereol Leprol. 1995;61(4):209–211.
- Van BT, Em DV, Anh NL, Hang DTN, Nhung VH, Tuan PV. Comparison of itraconazole and griseofulvin for treatment of tinea corporis in Bac Ninh Dermatology Hospital. J 108 Clin Med Pharm. 2021;15:26–30.
- Stolmeier DA, Stratman HB, McIntee TJ, Stratman EJ. Utility of laboratory test result monitoring in patients taking oral terbinafine or griseofulvin for dermatophyte infections. JAMA Dermatol. 2018;154(12):1409–16.
- Gupta AK, Adam P, Dlova N, Lynde CW, Hofstader S, Morar N, et al. Therapeutic options for the treatment of tinea capitis caused by Trichophyton species: griseofulvin versus the new oral antifungal agents, terbinafine, itraconazole, and fluconazole. Pediatr Dermatol. 2001;18(5):433–8.
- Olson JM, Troxell T. Griseofulvin. [Updated 2023 Jul 31]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing;
- Available from: https://www.ncbi.nlm.nih.gov/books/NBK537323/