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BMC Dermatology
Published in: BMC Dermatology 1/2018

Open Access 01-12-2018 | Research article

Expert Consensus on The Management of Dermatophytosis in India (ECTODERM India)

Authors: Murlidhar Rajagopalan, Arun Inamadar, Asit Mittal, Autar K. Miskeen, C. R. Srinivas, Kabir Sardana, Kiran Godse, Krina Patel, Madhu Rengasamy, Shivaprakash Rudramurthy, Sunil Dogra

Published in: BMC Dermatology | Issue 1/2018

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Abstract

Background

Dermatophytosis management has become an important public health issue, with a large void in research in the area of disease pathophysiology and management. Current treatment recommendations appear to lose their relevance in the current clinical scenario. The objective of the current consensus was to provide an experience-driven approach regarding the diagnosis and management of tinea corporis, cruris and pedis.

Methods

Eleven experts in the field of clinical dermatology and mycology participated in the modified Delphi process consisting of two workshops and five rounds of questionnaires, elaborating definitions, diagnosis and management. Panel members were asked to mark “agree” or “disagree” beside each statement, and provide comments. More than 75% of concordance in response was set to reach the consensus.

Result

KOH mount microscopy was recommended as a point of care testing. Fungal culture was recommended in chronic, recurrent, relapse, recalcitrant and multisite tinea cases. Topical monotherapy was recommended for naïve tinea cruris and corporis (localised) cases, while a combination of systemic and topical antifungals was recommended for naïve and recalcitrant tinea pedis, extensive lesions of corporis and recalcitrant cases of cruris and corporis. Because of the anti-inflammatory, antibacterial and broad spectrum activity, topical azoles should be preferred. Terbinafine and itraconazole should be the preferred systemic drugs. Minimum duration of treatment should be 2–4 weeks in naïve cases and > 4 weeks in recalcitrant cases. Topical corticosteroid use in the clinical practice of tinea management was strongly discouraged.

Conclusion

This consensus guideline will help to standardise care, provide guidance on the management, and assist in clinical decision-making for healthcare professionals.
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Metadata
Title
Expert Consensus on The Management of Dermatophytosis in India (ECTODERM India)
Authors
Murlidhar Rajagopalan
Arun Inamadar
Asit Mittal
Autar K. Miskeen
C. R. Srinivas
Kabir Sardana
Kiran Godse
Krina Patel
Madhu Rengasamy
Shivaprakash Rudramurthy
Sunil Dogra
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Dermatology / Issue 1/2018
Electronic ISSN: 1471-5945
DOI
https://doi.org/10.1186/s12895-018-0073-1

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