#MedicalCase

Tinea and antifungals (Dermatology)

Dr. Subhash Kashyap., MD DERMATOLOGY

 

Medical Case Details:

Tinea patients are not responding to antifungals. The reoccurrence rate after prolonged treatments are high. Results with Terbinafine and Itraconazole are disappointing. What are your experiences?

 


    Discussions


    Dr. Sornakumar L

    Sir ,
    Common problem faced by all dermatologist.
    It's all because of over the counter medications by patients and misuse of topical steroids from GPs.
    I usually inform the pt that treatment is for 3 to 6 months.
    Itraconazole as last resource.
    Try with fungicidal
    Or antifungal combo
    Once 90% mycological clearance, change over to pulse therapy.
    Follow with topical antifungal for atleast 2 months even after 100% mycological or clinical cure

    ▲ 1
    27.Mar, 01:19pm

    Dr. Subhash Kashyap
    Dermatologist

    Very true sir.
    some people are just not responding or reccuring.




    ▲ 1
    29.Mar, 09:37am

    Dr. Albana Greca

    Hello,

    Don't you think we should review the diagnosis? Plus on quality of the medications?
    For me, should further on patient's personal history, should understand why these changes and why they started at this point.
    Plus, as per my experience, patients start to take medication even based on friend's consultation.
    And we should ensure patient is taking medications as per our prescription. The pharmacy often changes therapy with the justification of "they have the same effect, they act the same".
    We should explain our patients to take the medications as prescribed in order to see and evaluate changes further.

    All the best.

    ▲ 1
    30.Mar, 02:01pm

    Dr. Subhash Kashyap
    Dermatologist

    Sir,
    in my experience as I spend a little time on counselling the patients about behaviour change, like avoiding moisture, sweating, taking bath daily, drying the body properly before taking on clothes,, changing undergarments frequently washing them properly and drying them in sunlight, like ironing the clothes in in Reverse side.

    prolonging the treatment specially topical treatment, two to three weeks after the lesions have healed has improved results in some patients but still I see many patients which actually are not responding to treatment and I am left with no other options to give them a break off 1 to 2 months and then to start the oral therapy again.
    Other Drugs like griseofulvin has also not shown any extra benefit in fact Side Effects for increasing.

    30.Mar, 10:01pm

    Dr. Soaniya Malempati

    Small question which is a safe antifungal for elderly presetig with Tinea ungum who have had a bypass with CAD and HT

    18.Apr, 09:08pm

    Dr. Soaniya Malempati

    Small question which is a safe antifungal for elderly presetig with Tinea ungum who have had a bypass with CAD and HT

    18.Apr, 09:08pm



Are you a doctor?

Please Login to comment or ask a question.

New to icliniq? Sign Up Now

 

 

 


Disclaimer: All medical case discussions published on this website is not intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek the advice from your physician or other qualified health-care providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website.