Management of tinea corporis, tinea cruris, and tinea pedis: A comprehensive review

Abstract

The prevalence of superficial mycotic infection worldwide is 20–25% of which dermatophytes are the most common agents. Recent developments in understanding the pathophysiology of dermatophytosis have confirmed the central role of cell-mediated immunity in countering these infections. Hence, a lack of delayed hypersensitivity reaction in presence of a positive immediate hypersensitivity (IH) response to trichophytin antigen points toward the chronicity of disease. Diagnosis, though essentially clinical should be confirmed by laboratory-based investigations. Several new techniques such as polymerase chain reaction (PCR) and mass spectroscopy can help to identify the different dermatophyte strains. Management involves the use of topical antifungals in limited disease, and oral therapy is usually reserved for more extensive cases. The last few years have seen a significant rise in the incidence of chronic dermatophyte infections of skin which have proven difficult to treat. However, due to the lack of updated national or international guidelines on the management of tinea corporis, cruris, and pedis, treatment with systemic antifungals is often empirical. The present review aims to revisit this important topic and will detail the recent advances in the pathophysiology and management of tinea corporis, tinea cruris, and tinea pedia while highlighting the lack of clarity of certain management issues.

Correlation ofIn VitroSusceptibility Based on MICs and Squalene Epoxidase Mutations with Clinical Response to Terbinafine in Patients with Tinea Corporis/Cruris

“…If the clinical response after 3 weeks was less than 50% or if new lesions appeared during this time, the patient's treatment was changed to TRB 250 mg BD. As 3 weeks has previously been recommended as the standard duration of treatment of tinea corporis/cruris with TRB 250 mg OD, this cutoff was chosen for shifting to a higher TRB dose (1,39). If Ͼ50% clinical clearance was achieved within 3 weeks, the same regimen was continued until complete cure and patients were assigned to group 2.…”

Epidemiology of Dermatophytes and Non Dermatophyte Molds among Patients Attending Rank Higher Specialized Dermatology Clinic, Addis Ababa, Ethiopia

“…An accurate diagnosis of dermatophytosis is important for its successful treatment. The risk of developing adverse drug reactions, the cost and long duration of the therapy, and possible interactions with concomitant medications all affects the importance of accurate diagnosis of the condition before commencing therapy [13,14]. In the present study, direct microscopy positivity rate is 41.8% and culture positivity rate is 46.5 % (Table 1).…”

Epidemiology of Dermatophytes and Non Dermatophyte Molds among Patients Attending Rank Higher Specialized Dermatology Clinic, Addis Ababa, Ethiopia

“…Currently, the diagnosis of dermatophytosis is confirmed by clinical examination and screening of the collected clinical specimen by direct microscopy and fungal culture [13]. The risk of developing adverse drug reactions, the cost and long duration of the therapy, and possible interactions with concomitant medications all affects the importance of accurate diagnosis of the condition before commencing therapy [13,14]. In the present study, direct microscopy positivity rate is 133/318(41.8%) and culture positivity rate is 148/318(46.5 %) ( Table: 1).…”