Efficacy and Safety of Voriconazole in the Treatment of Tinea Corporis and Cruris Infections
Keywords:
Voriconazole, Dermatophytosis, , Antifungal, Efficacy, Safety,Abstract
Background: The World Health Organization estimates that dermatophytes affect approximately 25% of the global population, indicating their widespread prevalence and impact on public health. Voriconazole, a newer second-generation triazole antifungal agent, has shown promise as an alternative treatment option for dermatophytosis. Objective: The objective of this study was to evaluate the efficacy and safety of Voriconazole in treating Tinea Corporis and Cruris. Methods: This single-center observational study enrolled 227 eligible participants aged between 18 and 70 years after providing written informed consent. Participants were categorized into new cases, resistant cases, and relapsing cases based on specific criteria. Baseline evaluations were conducted, including safety and disease assessments, before treatment initiation. Severity grading was noted for each patient. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS ver. 23). Results: Demographics revealed a male predominance (59%), with a mean age of 35.1 + 11.1 years. Most participants were unmarried (54.2%) and had no family history of the disease (66.1%). Majority were new cases (66.1%) with moderate disease severity (55.9%). Voriconazole therapy at week 12 resulted in an 85.5% "Complete Cure" response, with higher efficacy in males (61.3%) and younger age groups (58.2% aged 18-40 years). Side effects included nausea (8.8%) and vomiting (5.7%). Conclusion: The study concludes that voriconazole is effective for treating Tinea Corporis and Tinea Cruris infections, especially in new cases and those with mild to moderate severity. With an 85.5% complete cure rate at the 12-week assessment, voriconazole demonstrates promising efficacy, along with manageable side effectsReferences
Pires CA, Cruz NF, Lobato AM, Sousa PO, Carneiro FR, Mendes AM. Clinical, epidemiological, and therapeutic profile of dermatophytosis. A Bras Dermatol. 2014;89(2):259-64.
Doi: 10.1590/abd1806-4841.20142569.
Petrucelli MF, Abreu MHd, Cantelli BAM, Segura GG, Nishimura FG, Bitencourt TA, et al. Epi-demiology and Diagnostic Perspectives of Derma-tophytoses. Journal of Fungi. 2020; 6(4):310.
https://doi.org/10.3390/jof6040310
Alshehri BA, Alamri AM, Rabaan AA, Al-Tawfiq JA. Epidemiology of Dermatophytes Isolated from Clinical Samples in a Hospital in Eastern Saudi Arabia: A 20-Year Survey. J Epidemiol Glob Health. 2021;11(4):405-412.
Doi: 10.1007/s44197-021-00005-5.
Nweze EI, Eke IE. Dermatophytes and dermatophytosis in the eastern and southern parts of Africa. Med Mycol. 2018 ;56(1):13-28.
Doi: 10.1093/mmy/myx025.
Haro M, Alemayehu T, Mikiru A. Dermatophytosis and its risk factors among children visiting dermatology clinic in Hawassa Sidama, Ethiopia. Sci Rep. 2023;13(1):8630.
Doi: 10.1038/s41598-023-35837-7.
Bhatia VK, Sharma PC. Epidemiological studies on Dermatophytosis in human patients in Himachal Pradesh, India. Springerplus. 2014;3:134.
Doi: 10.1186/2193-1801-3-134.
Shahidullah M, Islam KA, Islam S, Asma AN, Sultana R, Rahman MM, et al. Systemic Therapy of Dermtophytosis with Voriconaole: A Clinical Observational Study of 250 Bangladeshi Patients. Mymensingh Med J. 2021;30(3):738-743.
Sahoo AK, Mahajan R. Management of tinea corporis, tinea cruris, and tinea pedis: A compre-hensive review. Indian Dermatol Online J. 2016;7(2):77-86.
Doi: 10.4103/2229-5178.178099.
Brescini L, Fioriti S, Morroni G, Barchiesi F. Antifungal Combinations in Dermatophytes. J Fungi (Basel). 2021;7(9):727.
Doi: 10.3390/jof7090727.
Salam MA, Al-Amin MY, Salam MT, Pawar JS, Akhter N, Rabaan AA, et al. Antimicrobial Resistance: A Growing Serious Threat for Global
Public Health. Healthcare. 2023; 11(13):1946.
https://doi.org/10.3390/healthcare11131946
Nande A, Hill AL. The risk of drug resistance during long-acting antimicrobial therapy. Proc Biol Sci. 2022;289(1986):20221444.
Doi: 10.1098/rspb.2022.1444.
Chinemerem Nwobodo D, Ugwu MC, Oliseloke Anie C, Al-Ouqaili MTS, Chinedu Ikem J, Victor Chigozie U, et al. Antibiotic resistance: The challenges and some emerging strategies for tackling a global menace. J Clin Lab Anal. 2022;36(9):e24655. Doi: 10.1002/jcla.24655.
Fisher MC, Alastruey-Izquierdo A, Berman J, Bicanic T, Bignell EM, Bowyer P, et al. Tackling the emerging threat of antifungal resistance to human health. Nat Rev Microbiol. 2022;20(9):557-571.
Doi: 10.1038/s41579-022-00720-1.
Hossain CM, Ryan LK, Gera M, Choudhuri S, Lyle N, Ali KA, et al. Antifungals and Drug Resistance. Encyclopedia. 2022; 2(4):1722-1737.
https://doi.org/10.3390/encyclopedia2040118
Pathadka S, Yan VKC, Neoh CF, Al-Badriyeh D, Kong DCM, Slavin MA, et al. Global Consumption Trend of Antifungal Agents in Humans From 2008 to 2018: Data From 65 Middle- and High-Income Countries. Drugs. 2022;82(11):1193-1205.
Doi: 10.1007/s40265-022-01751-x.
Ahmed SS, Ahmed SS, Haque MM, Tabassum F. Efficacy and Safety of Oral Voriconazole in Refractory and Recurrent Cases of Dermato-phytosis: A Prospective Study in a Tertiary Care Hospital in Bangladesh. Saudi J Med. 2022;7(11): 591-597.
Nahar D, Mohite P, Lonkar A, Chidrawar VR, Dodiya R, Uddin MJ, et al. An insight into new strategies and targets to combat antifungal resis-tance: A comprehensive review. Eur J Med Chem Rep. 2024;10:100120.
Chandrashekar BS, Poojitha DS. Evaluation of efficacy and safety of oral voriconazole in the management of recalcitrant and recurrent dermato-phytosis. Clin Exp Dermatol. 2022;47(1):30-36.
Doi: 10.1111/ced.14799.
Shahzad MK, Hassan T, Tahir R, Jawaid K, Khan MF, Naveed MA. Efficacy of Oral Voriconazole in the Treatment of Dermatophyte Infections (Tinea Corporis and Cruris). P JMHS 2022;16(2)’330-32.
Ayatollahi Mousavi SA, Mokhtari A, Barani M, Izadi A, Amirbeigi A, Ajalli N, et al. Advances of liposomal mediated nanocarriers for the treatment of dermatophyte infections. Heliyon. 2023 ;9(8):e18960. Doi: 10.1016/j.heliyon.2023.e18960.
Brigida S, Muthiah N. Pediatric Sedation: Preva-lence of Tinea Corporis and Tinea Cruris in Out-patient Department of Dermatology 02 Unit of a Tertiary Care Hospital. J of Pharmacol & Clin Res. 2017;3(1): 555602.
Gamage H, Sivanesan P, Hipler U, Elsner P, Wiegand C. “Superficial fungal infections in the department of dermatology, University Hospital Jena: A 7-year retrospective study on 4556 samples from 2007 to 2013”. Mycoses . 2020 ;63(6):558-565.
Das S, De A, Saha R, Sharma N, Khemka M, Singh S, et al. “The Current Indian Epidemic of Dermatophytosis: A Study on Causative Agents and Sensitivity Patterns.” Indian J Dermatol. 2020 ;65(2):118–122.
Khondker L. “Efficacy and safety of voriconazole in the treatment failure cases of Dermatophytosis”. The Gulf Journal of Dermatology and Venereology. 2020;27(2):24-30.
Kafi MAH, Akter M, Khan R, Ahmed SS, Hassan MS. Efficacy and Safety of Voriconazole in the treatment of resistant cases of Dermatophytosis. Z H Sikder Women’s Medical College Journal. 2020;2:3-6. Doi: 10.47648/zhswmcj.2020.v0201.01.
Majid I, Sheikh G, Kanth F, Hakak R. Relapse after oral terbinafine therapy in dermatophytosis: a clinical and mycological study. Indian journal of dermatology 2016;61(5):529-33.
Sharma P, Bhalla M, Thami GP, Chander J. Evaluation of efficacy and safety of oral terbinafine and itraconazole combination therapy in the management of dermatophytosis. Journal of Dermatological Treatment 2020;31(7):749-753.
Khatri PK, Kachhawa D, Maurya V, Meena S, Bora A, Rathore L, et al. Antifungal Resistance Pattern among Dermatophytes in Western Rajasthan. Int. J. Curr. Microbiol. App. Sci. 6(7):499-509.
Doi: https://doi.org/10.20546/ijcmas.2017.607.06
Khattab F, Elkholy BM, Taha M, Abd-Elbaset A, Fawzy M. Voriconazole is superior to combined itraconazole/isotretinoin therapy and itraconazole monotherapy in recalcitrant dermatophytosis. Mycoses. 2022 ;65(12):1194-1201.
Doi: 10.1111/myc.13517.
