|Year : 1990 | Volume
| Issue : 2 | Page : 130-131
Comparative efficacy of two commonly used antifungal agents and a topical steriod with chinoform against dermatophytoses
C Rajendran, S Kandhari, PK Prabhakaran
Two topical antifungal agents (toinaftate and miconazole nitrate) and one topical corticosteroid antifungal (betamethasone with 3% chinoform) cream were evaluated in 58 patients of tinea cruris and tinea corporis to study their comparative clinical efficacy. Miconazole nitrate was found to be more efficaceous than toinaftate while betamethasone chinoform cream had no appreciable therapeutic effect on tinea cruris and tinea corporis.
|How to cite this article:|
Rajendran C, Kandhari S, Prabhakaran P K. Comparative efficacy of two commonly used antifungal agents and a topical steriod with chinoform against dermatophytoses.Indian J Dermatol Venereol Leprol 1990;56:130-131
|How to cite this URL:|
Rajendran C, Kandhari S, Prabhakaran P K. Comparative efficacy of two commonly used antifungal agents and a topical steriod with chinoform against dermatophytoses. Indian J Dermatol Venereol Leprol [serial online] 1990 [cited 2020 Jul 6 ];56:130-131
Available from: http://www.ijdvl.com/text.asp?1990/56/2/130/3503
Dermatophytoses account for about 8-10% of the patients attending the dermatology service in hospitals in India. Among these cases, the bulk of the patients suffer from tinea corporis and tinea cruris. Although several therapeutic agents, systemic and/or topical, are being used currently for the management of various forms of dermatophytoses, information regarding the comparative clinical efficacy of these drugs is very meagre, especially with regards to the topical therapeutic agents. We have evaluated two commonly used topical antifungal agents and a topical steroid with 3% chinoform in patients having tinea corporis and/or tinea cruris.
Materials and Methods
Forty eight patients having tinea cruris and/ or tinea corporis were selected. None of the patients had used any drug for the ailment before coming for treatment. The patients included both males and females and ranged in age between 10 and 70 years. The clinical diagnosis was confirmed by examination of the skin scrapings in 10% KOH, and culture on Sabouraud glucose agar medium containing chloramphenicol and cycloheximide.
The topical ai tifungal agents selected for screening were, (1) tolnaftate (1% solution), (2) miconazole nitrate (2% cream) and (3) betamethasone 0.12% with 3% chinoform. The number of patients treated with these drugs was 34, 14 and 10 respectively. The patients were advised to apply the medicines twice daily until the lesions disappeared completely. No adjuvant therapy was given to any of these patients during the course of the treatment. The clinical efficacy of the drugs was assessed on the basis of the clinical cure of the lesions namely erythema, itching and scaling.
Out of a total of 58 patients included in this study, KOH positivity was observed in 45 (77.6%) patients and culture positivity in 30 (51.7%) patients. Trichophyton rubruam was isolated from 17 patients, T. mentagrophytes and T. simii from 3 each, Trichophyton spp (which could not be identified due to variability in the morphological characters) from 4 patients, Microsporum sp from 1 and Epidermophyton floccosama from 2 patients.
Of the 34 patients treated with tolnaftate 15 (44%) showed clinical cure within 15 days, 11 (32.3%) within 30 days, 3 (8.8%) within 45 days, 4 (11.7%) within 60 days and it took 90 days for the clinical cure for 1 (2.9%) patient. Among the patients treated with miconazole nitrate, out of 14 patients, 8 (57.3%) improved completely by the 15th day, 4 (28.6%) in 30 days and 2 (14.3%) within 45 days. The difference in the efficacy of tolnaftate and miconazole nitrate was statistically not significant.
In the patients treated with betamethasonechinoform cream, even though they did show some initial improvement in itching on the 15th day followed by a very slow response in erythema and scaling, the patients clinically deteriorated after 30 days so much so that around the 90th day the addition of an antifungal agent like tolnaftate or miconazole nitrate became necessary for complete cure.
T. rubrurn was the commonest dermatophyte isolated from our patients. It seems, betamethasone-chinoform cream when used alone is of little therapeutic value. Clinical improvement with miconazole nitrate was much better than tolnaftate as all the patients recovered by the 45th day, whereas it took a much longer period with tolnaftate, but this difference was statistically not significant. One patient treated with tolnaftate did not show improvement even by the 90th day. This we presume was due to application of the drug irregularly as other factors were ruled out in the history.
Trade names of the drugs
Tolnaftate - Tinaderm
Miconazole nitrate - Daktarin Betamethasone chinoform
cream - Betnovate C
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|3||Kobayashi GS and Medoff G : Antifungal agents Recent developments, Ann Rev Microbiol, 1977; 31 : 291-308.|