{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T22:23:07Z","timestamp":1790893387200,"version":"4.1.0"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Recurrent dermatophytosis is becoming arduous to treat. Recently, oral itraconazole with oral isotretinoin was successful in a patient suffering from recurrent dermatophytosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To evaluate if oral isotretinoin confers any added benefit over oral terbinafine in the treatment of recurrent dermatophytosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>This was an open-label randomized clinical trial including 100 adult patients with recurrent tinea cruris and\/or tinea corporis randomized into two groups; Group A (oral isotretinoin 0.5 mg\/kg\/day and oral terbinafine 250 mg twice daily) and Group B (oral terbinafine 250 mg twice daily) for 4 weeks, and followed up for 3 months. Fungal culture and antifungal susceptibility testing against terbinafine, fluconazole, amphotericin B, itraconazole, and griseofulvin were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Out of the 100 patients, 91 patients (44 in Group A and 47 in Group B) completed the trial. Complete cure was seen in 19\/44 (43.18%) patients in Group A and 20\/47 (42.55%) patients in Group B (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.951). Recurrence occurred in 12\/19 (63.1%) patients in Group A and 13\/20 (65%) patients in Group B (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.904). Cheilitis and dryness of lips were the most common adverse effects seen in 32\/44 (72.73%) patients in Group A. A total of 50 cultures were grown. The commonest species isolated was\n                      <jats:italic toggle=\"yes\">Trichophyton interdigitale<\/jats:italic>\n                      in 36 (72%) patients, having a mean minimum inhibitory concentration of 3.13 \u03bcg\/mL for terbinafine. However, for itraconazole, it was 0.13 \u03bcg\/mL, and varied minimum inhibitory concentration (MIC) values were seen for fluconazole, griseofulvin, and amphotericin B.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The addition of isotretinoin to terbinafine has no added benefit in treating patients with recurrent dermatophytosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/idoj.idoj_167_21","type":"journal-article","created":{"date-parts":[[2021,11,21]],"date-time":"2021-11-21T11:01:13Z","timestamp":1637492473000},"page":"820-825","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":8,"title":["Oral Isotretinoin Combined with Oral Terbinafine Versus Oral Terbinafine Alone to Treat Recurrent Dermatophytosis"],"prefix":"10.4103","volume":"12","author":[{"given":"Kaushal K.","family":"Verma","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gridharan","family":"Senthilnathan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saurabh","family":"Bhatia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Immaculata","family":"Xess","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vishal","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sada Nand","family":"Dwivedi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanika","family":"Sahni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-4-20240828","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/s12895-018-0073-1","article-title":"Expert consensus on the management of dermatophytosis in India (ECTODERM India)","volume":"18","author":"Rajagopalan","year":"2018","journal-title":"BMC Dermatol"},{"key":"R2-4-20240828","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1111\/myc.12772","article-title":"High terbinafine resistance in Trichophyton interdigitale isolates in Delhi, India harbouring mutations in the squalene epoxidase gene","volume":"61","author":"Singh","year":"2018","journal-title":"Mycoses"},{"key":"R3-4-20240828","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.mycmed.2019.100913","article-title":"Antifungal resistance in dermatophytes: Emerging problem and challenge for the medical community","volume":"29","author":"Monod","year":"2019","journal-title":"J Mycol Med"},{"key":"R4-4-20240828","doi-asserted-by":"crossref","first-page":"1841","DOI":"10.1007\/s10096-018-3317-4","article-title":"Antifungal drug susceptibility profile of clinically important dermatophytes and determination of point mutations in terbinafine-resistant isolates","volume":"37","author":"Salehi","year":"2018","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"R5-4-20240828","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1111\/myc.13091","article-title":"Alarming India-wide phenomenon of antifungal resistance in dermatophytes: A multicentre study","volume":"63","author":"Ebert","year":"2020","journal-title":"Mycoses"},{"key":"R6-4-20240828","doi-asserted-by":"crossref","first-page":"579","DOI":"10.4103\/0378-6323.183632","article-title":"Successful treatment of recurrent dermatophytosis with isotretinoin and itraconazole","volume":"82","author":"Ardeshna","year":"2016","journal-title":"Indian J Dermatol Venereol Leprol"},{"key":"R7-4-20240828","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1128\/JCM.03019-15","article-title":"Multilaboratory evaluation of in vitro antifungal susceptibility testing of dermatophytes for ME1111","volume":"54","author":"Ghannoum","year":"2016","journal-title":"J Clin Microbiol"},{"key":"R8-4-20240828","doi-asserted-by":"crossref","first-page":"529","DOI":"10.4103\/0019-5154.190120","article-title":"Relapse after oral terbinafine therapy in dermatophytosis: A clinical and mycological study","volume":"61","author":"Majid","year":"2016","journal-title":"Indian J Dermatol"},{"key":"R9-4-20240828","doi-asserted-by":"crossref","first-page":"118","DOI":"10.4103\/ijd.IJD_203_19","article-title":"The current Indian epidemic of dermatophytosis: A study on causative agents and sensitivity patterns","volume":"65","author":"Das","year":"2020","journal-title":"Indian J Dermatol"},{"key":"R10-4-20240828","doi-asserted-by":"crossref","first-page":"554","DOI":"10.4103\/ijdvl.IJDVL_526_17","article-title":"End of the road for terbinafine.Results of a pragmatic prospective cohort study of 500 patients?","volume":"84","author":"Singh","year":"2018","journal-title":"Indian J Dermatol Venereol Leprol"},{"key":"R11-4-20240828","doi-asserted-by":"crossref","first-page":"284","DOI":"10.4103\/ijd.IJD_548_19","article-title":"Efficacy of terbinafine and itraconazole in different doses and in combination in the treatment of tinea infection: A randomized controlled parallel group open labeled trial with clinico-mycological correlation","volume":"65","author":"Singh","year":"2020","journal-title":"Indian J Dermatol"},{"key":"R12-4-20240828","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1111\/j.1439-0507.1994.tb00278.x","article-title":"Enzyme patterns of dermatophytes","volume":"37","author":"Brasch","year":"1994","journal-title":"Mycoses"},{"key":"R13-4-20240828","first-page":"69","article-title":"Author Hni Hay","volume":"83","author":"Ardeshna","year":"2017","journal-title":"Indian J Dermatol Venereol Leprol"},{"key":"R15-4-20240828","doi-asserted-by":"crossref","first-page":"730","DOI":"10.4103\/ijdvl.IJDVL_1012_16","article-title":"Intracutaneous pharmacokinetics of oral antifungals and their relevance in recalcitrant cutaneous dermatophytosis: Time to revisit basics","volume":"83","author":"Sardana","year":"2017","journal-title":"Indian J Dermatol Venereol Leprol"},{"key":"R16-4-20240828","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1007\/s00005-019-00562-5","article-title":"Retinoids as an immunity-modulator in dermatology disorders","volume":"67","author":"Chen","year":"2019","journal-title":"Arch Immunol Ther Exp"},{"key":"R18-4-20240828","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1111\/j.1365-2230.1990.tb02074.x","article-title":"A comparative double-blind study of terbinafine (Lamisil) and griseofulvin in tinea corporis and tinea cruris","volume":"15","author":"Del Palacio Hernanz","year":"1990","journal-title":"Clin Exp Dermatol"},{"key":"R19-4-20240828","doi-asserted-by":"crossref","first-page":"e01038","DOI":"10.1128\/AAC.01038-18","article-title":"Correlation of in vitro susceptibility based on MICs and squalene epoxidase mutations with clinical response to terbinafine in patients with tinea corporis\/cruris?","volume":"62","author":"Khurana","year":"2018","journal-title":"Antimicrob Agents Chemother"},{"key":"R20-4-20240828","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1111\/bjd.19146","article-title":"Limited effectiveness of four oral antifungal drugs (fluconazole, griseofulvin, itraconazole and terbinafine) in the current epidemic of altered dermatophytosis in India: Results of a randomized pragmatic trial","volume":"183","author":"Singh","year":"2020","journal-title":"Br J Dermatol"},{"key":"R21-4-20240828","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1007\/s11046-008-9110-7","article-title":"Antifungal resistance mechanisms in dermatophytes","volume":"166","author":"Martinez-Rossi","year":"2008","journal-title":"Mycopathologia"},{"key":"R22-4-20240828","doi-asserted-by":"crossref","first-page":"277","DOI":"10.4103\/ijd.IJD_456_18","article-title":"A study of In vitro antifungal susceptibility patterns of dermatophytic fungi at a tertiary care center in Western India","volume":"64","author":"Poojary","year":"2019","journal-title":"Indian J Dermatol"},{"key":"R23-4-20240828","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1055\/s-0040-1713063","article-title":"Current trends of dermatophytosis in Eastern Odisha","volume":"12","author":"Jain","year":"2020","journal-title":"J Lab Physicians"},{"key":"R24-4-20240828","doi-asserted-by":"crossref","first-page":"17","DOI":"10.21276\/ijchmr.2016.2.2.03","article-title":"Clinico-mycological profile of dermatophytic infections at a tertiary care hospital in North India","volume":"2","author":"Kucheria","year":"2016","journal-title":"Int J Community Health Med Res"},{"key":"R25-4-20240828","doi-asserted-by":"crossref","first-page":"17","DOI":"10.3390\/jof3020017","article-title":"Molecular identification and antifungal susceptibility patterns of clinical dermatophytes following CLSI and EUCAST guidelines","volume":"3","author":"Dabas","year":"2017","journal-title":"J Fungi (Basel"},{"key":"R26-4-20240828","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.1111\/ijd.12100","article-title":"In vitro activities of antifungal drugs against dermatophytes isolated in Tokat, Turkey","volume":"52","author":"Yeni\u015fehirli","year":"2013","journal-title":"Int J Dermatol"},{"key":"R27-4-20240828","doi-asserted-by":"crossref","first-page":"388","DOI":"10.4103\/ijdvl.IJDVL_319_18","article-title":"In vitro susceptibility of dermatophytes to oral antifungal drugs and amphotericin B in Uttar Pradesh, India","volume":"85","author":"Singh","year":"2019","journal-title":"Indian J Dermatol Venereol Leprol"},{"key":"R28-4-20240828","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1111\/bjd.19562","article-title":"The science and rationale of arriving at the correct drug and dosimetry of griseofulvin, fluconazole, terbinafine and itraconazole in superficial dermatophyte infections: An important step before a pragmatic trial","volume":"184","author":"Sardana","year":"2021","journal-title":"Br J Dermatol"}],"container-title":["Indian Dermatology Online Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/idoj.IDOJ_167_21","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:14:25Z","timestamp":1787166865000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/idoj.IDOJ_167_21"}},"subtitle":["An Open-Label Randomised Clinical Trial"],"short-title":[],"issued":{"date-parts":[[2021,11]]},"references-count":26,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.4103\/idoj.idoj_167_21","relation":{},"ISSN":["2229-5178"],"issn-type":[{"value":"2229-5178","type":"print"}],"subject":[],"published":{"date-parts":[[2021,11]]}}}