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Year : 1993  |  Volume : 59  |  Issue : 2  |  Page : 57-59

Comparative study of topical imidazoles in dermatophytosis

Correspondence Address:
R P Sharma

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Source of Support: None, Conflict of Interest: None

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A total of 270 patients suffering from dermatophytosis, divided in 3 equal groups of 90 patients each, were treated with topical miconazole, econazole and clotrimazole for a period of 6 weeks. Moconozole was found slightly superior amongst the 3 with cure rate of 97.7%, while 93.3% cure rate was observed with econazole and 92.8% with clotrimazole. Trichophyton rubrum was the commonest fungal species isolated on culture.

Keywords: Miconazole, Econazole, Clotrimazole, Dermatophytosis

How to cite this article:
Sharma R P, Sharma N K, Gupta S, Agarwal A K. Comparative study of topical imidazoles in dermatophytosis. Indian J Dermatol Venereol Leprol 1993;59:57-9

How to cite this URL:
Sharma R P, Sharma N K, Gupta S, Agarwal A K. Comparative study of topical imidazoles in dermatophytosis. Indian J Dermatol Venereol Leprol [serial online] 1993 [cited 2020 Aug 5];59:57-9. Available from:

  Introduction Top

Imidazole derivatives (miconazole, econazole and clotrimazole) are now well established topical antifungal agents. They are not only effective against dermatophytes and yeasts but also against gram positive bacteria. The aim of the present study was to compare the efficacy of miconazole, econazole and clotrimazole in the treatment of dermatophytosis.

  Material and Methods Top

270 clinically diagnosed and untreated patients of dermatophytosis attending out-patient department at SVBP Hospital, LLRM Medical College, Meerut were included in this study. The diagnosis was confirmed by KOH smear examination. For identification of fungal species cultures were carried out by inoculating scraped material on Sabouraud's media.

Patients were divided in 3 groups of 90 patients each. Each group was treated with 1% cream of miconazole, econazole and clotrimazole respectively. Patients were advised to apply cream twice daily on affected sites. Patients were followed up at weekly intervals for 6 weeks. Any adverse effect(s), clinical response and mycological findings were recorded on each visit. On the basis of therapeutic response, improvement was graded as follows :

Grade 0 : No improvement.

Grade I Persistence of few papular lesions or erythema with mild to moderate itching.

Grade 11 Scaly lesions with or without itching.

Grade III : Disappearance of original lesions with or without residual pigmentation.

Drop outs were discarded from the study.

  Results Top

In each group, there were 90 cases which included T. corporis (30), T. cruris (28), T. manuum (18), T. pedis (6) and mixed type (8). All cases were KOH positive. Fungal species isolated were Trichophyton rubrum (201), Trichophyton mentagrophytes (41) and Epidermo­ phyton floccosum (28).

In first group out of 90 patients treated with miconazole 88 (97.7%) had complete cure while 2 patients had partial response. In second group out of 90 patients treated with econazole 84 (93.3%) had complete cure while 6 patients had only partial response. In third group only 83 (92.2%) out of 90 patients treated with clotrimazole were completely cured while rest 7 patients had partial response. The details of therapeutic response according to clinical types is shown in Table I.

No adverse effect was observed in any group.

  Comments Top

Earliest response and highest cure rate (97.7%) were observed in patients treated with miconazole while earlier reports varied from 60% to 100% with this drug as reported by Botter (1971), [1] Svejgaard (1973), [2] Haribhakti et al (1974), [3] Gentles et al (1975), [4] Shroff et al (1975), [5] Kaur et al (1979), [6] and Rajendran et al (1990). [7]

Patients treated with econazole and clotrimazole showed 93.3% and 92.2% cure rates respectively. With these drugs almost similar results are reported by other workers, Shimzaki (1978), [8] Adam et al (1981). [9]sub Sethi et al (1983). [10]

In this study, though the response with miconazole was slightly better than other 2 drugs but the overall difference was not statistically significant.

  References Top

1.Botter A A. Topical treatment of nail and skin infections with miconazole, a new broad-spectrum antimycotic. Mykosen 1971; 14: 187-8.  Back to cited text no. 1    
2.Svejgaard E. Double - blind trial of miconazole in dermatomycosis. Acta Dermato-venereol 1973; 53 : 497 - 9.  Back to cited text no. 2  [PUBMED]  
3.Haribhakti P B, Vohra I. Clinical trial of topically applied miconazole nitrate in dermatomycosis. Ind J Dermatol Venereol Leprol 1974; 40 : 268 - 70.  Back to cited text no. 3    
4.Gentles J C, Jones G R, Roberts D T. Efficacy of miconazole in the topical treatment of tinea pedis in sportmen. Br J Dermatol 1975; 79 : 936 - 8.  Back to cited text no. 4    
5.Shroff H J, Miskeen A K, Shroff J C. Miconazole in superficial mycosis. Ind J Dermatol Venereol Leprol 1975; 41 : 150-2.  Back to cited text no. 5    
6.Kaur M, Sarin R C, Tyagi S C. Miconazole versus salicylic benzoic acid ointment in the treatment of dermatophytosis. Ind J Dermatol Venereol Leprol 1979; 46: 445-8.  Back to cited text no. 6    
7.Rajendran C, Kandhari S, Prabhakaran P K. Comparative efficacy of two commonly used antifungal agents and a topical steroid with chinoform against dermatophytosis. Ind J Dermatol Venereol Leprol 1990; 56: 130-1.  Back to cited text no. 7    
8.Shimajaki T. Clinical evaluation of ciclopirox olamine and clotrimazole in tinea cruris. Nichinihon J Dermatol 1978; 40: 351 -4.  Back to cited text no. 8    
9.Adam W, Peil H G, Saropoulos C, Vanderbeke 0. Clinical results with the antimycotic agents ciclopirox olamine and clotrimazole. Arzneimittel - Forschung 1981; 31 : 1360 - 3.  Back to cited text no. 9    
10.Sethi N C. Comparative study of econazole and povidone iodine in management of dermatophytosis. Ind J Dermatol Venereol Leprol 1983; 49: 102-5.  Back to cited text no. 10    


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