EFFICACY OF ITRACONAZOLE VS ITRACONAZOLE PLUS ISOTRETINOIN IN TREATMENT OF CHRONIC RECURRENT TINEA

Dr. Nour Mousa*, Dr. Mohamed Adel Ismail, Dr. Roula Badour

ABSTRACT

Background: Dermatophytes are the most common skin infections and are increasingly seen in daily clinical practice, with unusual presentations, running a chronic recurrent course and seems to be more resistant to systemic and topical conventional treatment, necessitating an effective adjuvant drug that reduces the possibility of recurrence and resistance in combination with systemic antifungals. Aim: This study aimed to assess and compare efficacy and safety of itraconazole vs itraconazole plus isotretinoin in treatment of chronic recurrent tinea. Materials and methods: This was a randomized controlled comparative study was conducted, included 40 patients with chronic recurrent tinea corporis or tinea cruris, were randomly divided into two treatment groups: 20 patients treated with itraconazole plus isotretinoin and 20 patients treated with itraconazole alone, for 4 weeks, with monthly follow- up for 6 months after treatment to assess recurrence. Side effects of both treatments were also assessed. Results: After 4 weeks of treatment, complete cure was recorded in 90% of patients in the first group and 70% of patients in the second group with a statistically significant difference (p: 0.01). During the follow- up after treatment, recurrence was recorded in 11,1% of patients in the first group and 42,9% of patients in the second group with a statistically significant difference (p:0.01). Side effects were more in the second group and the most common was skin and mucosal dryness. Conclusion: Combination therapy with oral itraconazole and isotretinoin is efficient and safe for the treatment of chronic recurrent tinea, as it induces earlier complete cure with a significant reduction of recurrence rate.

Keywords: Dermatophytosis, itraconazole, isotretinoin.