How to treat recalcitrant tinea incognito?

Question

Hello doctor,

I am a known case of eczema since 4 years. My eczema subsided and later developed tinea incognito since three years. My doctor advised Itraconazole oral and topical Sertaconazole, Lulliconazole, and Eberconazole on different relapses. Initially, I was responding well with oral Itraconazole which is taken for three to four weeks but since the last three months, I am having recalcitrant tinea this time. My doctor kept me on Terbinafine 250 mg BD for three weeks. I responded well but started developing lesions on the third week while still on Terbinafine. Pleas help me with my recalcitrant tinea incognito.

Answer 1

Hi,

Welcome to icliniq.com.

Tinea incognito is a condition when a fungal infection is treated with topical steroids the symptoms subside but the fungal growth continuous and lesions are not visible, but when the steroid application is stopped larger and resistant lesions appear. You have taken multiple courses of Itraconazole and Terbinafine and there are recurrences. This is quite common in fungal infection of these days. Treatment in your case needs to be modified. Kindly send me a photo. Please get done renal function test and Liver function test.

Answer 2

Hi,

Welcome back to icliniq.com.

Longer course of treatment is helpful in resistant cases like yours. Griseofulvin has increased cure rate in such cases in my experience. Itraconazole is a drug of choice. Buy Canditral. Do not use steroid combination cream. Lesions clear within 10 days but recur if treatment stops earlier than four weeks in your case. Response may vary from person to person. Follow schedule and prevention strictly. I hope this helps.

Answer 3

hi relapses are common in fungal infection. if you have taken drugs and still having relapse I advise you to have drug rest for few months as drugs are toxic to organs...fungal resistant is very problematic. and vary person to petson..I don't want to give you false hope. continue terbinafine cream twice daily and keep dry.