Salih, Raad Ibrahim (2026) Efficacy of Combined Oral Itraconazole and Griseofulvin Regimen in Treatment of Chronic and Recurrent Tinea Corporis and Tinea Cruris Infections. Central Asian Journal of Medical and Natural Science, 7 (1). ISSN 2660-4159

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Abstract

Dermatophytosis is still a major worldwide health problem, causing an estimated 20–25% of the world's population to suffer from infections caused by species of Trichophyton, Microsporum, or Epidermophyton, with the majority of cases involving tinea pedis and tinea corporis. A number of fungal strains have developed resistance to the drugs previously used to treat them, especially Trichophyton indotineae, which has made the epidemiology of the condition far more complex and made chronic, recurrent and drug-resistant infections more common. Standard oral antifungal monotherapy often results in sub-optimal clinical response, failure of treatment and high relapse rates, particularly given at standard doses for standard durations. This study was a comparative trial of oral itraconazole monotherapy with a combination regimen of griseofulvin to evaluate the efficacy of the two treatment regimens for eight weeks in the treatment of chronic and recurrent tinea corporis and tinea cruris. The clinical study was conducted from 1st of January 2024 to 1st of September 2024 at the Dermatology Outpatient Unit of Samarra General Hospital and private dermatology clinic in Samarra city, Salahaddin Governorate, Iraq, through a comparative study. 80 patients with chronic tinea corporis or tinea cruris or both (duration of the disease >3 months) were recruited and split equally into two groups. Group I (n = 40) was treated with a cyclic regimen of itraconazole 200 mg daily for 4 days followed by griseofulvin 500 mg (morning) and 250 mg (night) for 3 days then 4 days, and this cycle was repeated every week for 8 weeks. The group II (n = 40) was given itraconazole 200 mg twice a day for eight weeks. Both groups were also treated with topical clotrimazole cream twice a day and ketoconazole shampoo once a day. Patients received follow-up for 16 weeks once a month. Complete cure (negative microscopy and elimination of all clinical symptoms), marked cure, partial cure, and recurrence rate were outcome measures. Chi-square and Fisher's exact tests were used for statistical analysis in the SPSS software, version 22. A p-value < 0.05 was considered as significant. Groups were not different with respect to age, gender, residence, family history or type of infection at baseline. The complete cure rate for Group I (30%) was significantly greater than Group II (17.5%) at the 2nd visit (4 weeks) (p = 0.05). In Group I, the complete cure percentage was 77.5% at the third visit (8 weeks) while in Group II, it was 47.5% (p = 0.02). At the fourth visit (16 weeks), the relapse rate was 12.5% for Group I while it was 40% for Group II (p = 0.01). None of the serious adverse effects were reported during the study period. Oral itraconazole + griseofulvin had significantly greater efficacy than itraconazole alone in the treatment of chronic and recurrent tinea corporis and tinea cruris, resulting in higher complete cure rates and significantly lower relapse rates. This may be due to the fact that the two agents act in complementary ways; itraconazole inhibits ergosterol biosynthesis, and griseofulvin does so by inhibiting microtubule assembly. These results indicate the need for combination antifungal treatment in today's age of increasing antifungal resistance. Treatment strategies should incorporate antifungal susceptibility testing and molecular diagnostics such as SQLE mutation detection to enhance clinical response to therapy in individual patients moving forward.

Item Type:	Article
Uncontrolled Keywords:	Dermatophytosis, Tinea Corporis, Tinea Cruris, Itraconazole, Griseofulvin, Combination Therapy, Antifungal Resistance, Trichophyton Indotineae
Subjects:	H Social Sciences
Depositing User:	admin eprints
Date Deposited:	31 Oct 2026 10:36
Last Modified:	31 Oct 2026 10:36
URI:	http://eprints.umsida.ac.id/id/eprint/17330

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