Management of Superficial Mycotic Infections: A Review

Superficial mycotic infections of  skin and nails are  the most common diseases seen in our daily practice and the main causative groups are dermatophytes, yeasts and moulds. The degree of immunosuppression and the number of immunosuppressed patients are increasing at an unprecendented pace, hence the management of dermatophytoses will be a challenge to mankind in the years to come.The increasing number of antifungal agents, reformulations of existing agents and novel treatment strategies have all improved the management of fungal infections, but still the infections are associated with high mortality. Currently, topical azoles and allylamines are used for the treatment of Cutaneous mycoses with disadvantages like long duration of therapy, which leads to poor compliance and a high relapse rate. Assessment of efficacy, Quality of life (QOL) and Medication adherence are important issues in all areas of clinical medicine, including dermatology. Here the clinical efficacy was assessed based on signs and symptoms severity score and global clinical response, Dermatology life quality by Finlay and Khan’s 10 question Dermatology Life Quality Index (DLQI) and adherence by medication adherence questionnnaire. Both Terbinafine (250–500 mg/day for 2–6 weeks) and Itraconazole (100–200 mg/day for 2–4 weeks) appear to be effective for limited disease (tinea corporis/cruris/pedis). However, an appropriate dose and duration of administration which can produce mycologic cure and prevent recurrence remains elusive. This review also highlights the huge research gaps in the management of cutaneous dermatophytosis which need to be plugged to provide better and effective care to the patients.