Comparative Clinical Outcomes of Three Itraconazole Regimens in Tinea Corporis: A Prospective Nonrandomized Real-World Observational Study from Bangladesh
DOI:
https://doi.org/10.66344/jpad.v36i3.3495Keywords:
Tinea corporis, dermatophytosis, itraconazole, clinical cureAbstract
Background Chronic and recurrent tinea corporis is increasingly difficult to manage in South Asia, and itraconazole regimens used in routine practice vary in dose, schedule, and formulation.
Objective To compare clinical cure and six-month relapse rates among three itraconazole-based treatment strategies.
Methods Patients aged 15-50 years with clinically diagnosed tinea corporis were enrolled. Tinea corporis was operationally defined as annular or polycyclic erythematous scaly plaque(s) on the trunk and/ or extremities with an active or advancing border, with or without pruritus. Seventy-two patients entered the study; 60 completed treatment (20/group). Group A received itraconazole capsules 200 mg twice daily for 2 weeks then 100 mg twice daily for 6 weeks; Group B received capsules 100 mg twice daily for 8 weeks; and Group C received tablets 200 mg once daily for 8 weeks. All groups received identical adjunctive topical therapy.
Results Clinical cure occurred in 19/20 (95%), 16/20 (80%), and 9/20 (45%) patients in Groups A, B, and C, respectively (P=.001). Among cured patients, relapse occurred in 2/19 (10.5%), 5/16 (31.3%), and 7/9 (77.8%), respectively (P=.002). Safety-related discontinuations included leg oedema (n=6), drug interactions (n=3), headache (n=2), and suspected cardiac toxicity (n=1).
Conclusion The induction–maintenance capsule strategy was associated with the highest clinical cure and lowest relapse. These exploratory findings require confirmation in adequately powered randomized trials with mycological confirmation.
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