Dhiraj Dhoot

Introduction: One of the most striking change in the current scenario is the increasing occurrence of nonalbicans vulvovaginal candidiasis (VVC), which is considered as the major cause of recurrence, relapse and chronic VVC in India. In the present study we evaluated the effectiveness of three different regimens of itraconazole in the treatment of acute VVC. Materials and Methods: The present randomised, three arm comparative clinical study involved 123 women aged 18 years or above with symptomatic acute VVC. These patients were randomised (41 patients in each group) to receive either itraconazole 200 mg twice daily for 1 day (group I), 200 mg twice daily for 2 days (group II) or 100 mg twice daily for 3 days (group III). Effectiveness was evaluated on the basis of clinical cure (total symptom score), mycological cure (negative KOH test). Results: All the groups were effective in relieving signs and symptoms (p Conclusion: In the present study, 2 day high dose itraconazole therapy was found to have better effectiveness compared to conventional regimens. Longer duration of therapy might be required to attain even better cure rates, especially when the incidence of Non Albicans vulvovaginal candidiasis is rising in all parts of the country. Keywords: Itraconazole, Acute, Vulvovaginal candidiasis, Non-albicans candida.

Introduction: Super bioavailable itraconazole (SBITZ) is a newer formulation of itraconazole which is recently launched in India. But there is no published clinical evidence of SBITZ in the management of dermatophytosis in Indian patients. Materials and Methods: A Real world retrospective data analysis was conducted with 346 dermatologists across India to assess the response of Indian patients with dermatophytosis who were prescribed super bioavailable itraconazole 50 mg twice a day for 4 weeks. Results: Out of 4625 patients’ data, 2743 were included for final analysis. Mean age of patients was 36.1712.05 years with male preponderance. Most of the patients were diagnosed as T. cruris. At the end of treatment, 51% of patients achieved complete clinical cure while 46% achieved clinical improvement (>50% symptom clearance) and 3% were labelled as clinical failure. About 70% patients achieved clearance in body surface area. Mean total symptom score (TSS) was reduced to 0.741.1 from 7.291.73 while mean BSA score was reduced from 1.960.83 to 0.380.65 (p Conclusion: Patients treated with super bioavailable itraconazole showed greater improvement in clearance of symptoms as well as lesions. Additionally, it showed significant improvement in naïve, recurrent and chronic patients enabling its placement in armamentarium of management of all types of dermatophytosis. Keywords: Super bioavailable itraconazole, Chronic, Naïve, Recurrent, BSA, Real world.

Introduction: Contact dermatitis is one the commonest dermatological condition which is managed by topical corticosteroids. Mid potent topical corticosteroids are commonly prescribed but there is no any comparative data between mometasone furoate and fluticasone propionate in the management of dermatitis. Materials and Methods: A real world retrospective study was conducted across India to compare the clinical assessment of mometasone 0.1% cream and fluticasone 0.005% cream in the management of contact dermatitis at 236 dermatology clinics. Results: A data of 1106 patients were included in this analysis in which 598 were included in mometasone group while 508 in fluticasone group. At the end of 2 weeks, 216 patients (36.1%) in mometasone and 129 patients (25.4%) in fluticasone group achieved complete clearance of symptoms (p Conclusion: Both, mometasone furoate and fluticasone propionate were effective and safe in treatment of eczema/dermatitis. But mometasone furoate had shown significantly better effectiveness as compared to fluticasone in all predisposing factors for the disease. Keywords: Dermatitis, Mometasone, Fluticasone, Real world.

Background: Second generation anti histamines are first line therapy as recommended by many guidelines for Chronic spontaneous urticaria (CSU). Bilastine, non-sedative H1-antihistamine is recently approved in India for the management of CSU. Materials and Methods: A real world retrospective study was conducted across India to assess the  response of CSU patients who were switched over to bilastine after non satisfactory response to other antihistamines at 140 dermatology clinics. Results: A data of 518 patients’ were included in this analysis. Mean age of the patients was 35.3 12.3 years while mean disease duration was 7.089.3 months. Baseline mean UCT score of 8.6 3.02 was improved to 13.05 2.9 in 28 days (p Conclusion: Authors concluded that in patients with inadequate response to commonly used antihistamines at licensed dose, switch over to bilastine resulted, not only in reliving the symptoms of CSU but also added to the Patients’ satisfaction with the drug. Keywords: Bilastine, Urticaria antihistamines, Real world, Refractory.

Upper respiratory tract infections (URTI) are one of the commonest cause for a patient’s visit to outpatient department (OPD). Short course therapies with penicillin and cephalosporin class of antibiotics are commonly prescribed in URTI cases. This study was a retrospective, multicentre, observational cohort analysis, planned to evaluate the effectiveness and safety of Cefixime 400 mg per day in patients of URTI, using WURSS 21 score. We analysed the data of 200 patients who were prescribed Cefixime for URTI. Most of the patients (55%) were male. The baseline mean WURSS score of 41.09 33.45 decreased to 25.74 22.29 [(-37.3%), p value patients reported adverse effects. The findings of the present survey confirm the effectiveness and safety of short course of Cefixime therapy in URTI. Keywords: URTI, Cefixime, WURSS, India.

Acne is one of the most common skin diseases seen in clinical practice and is caused by multiple factors. Epidemiological data on acne are limited from developing countries. Using a questionnaire survey, the epidemiological data of acne were evaluated with a view to establishing possible contributing etiological factors in dermatology practice in India. Out of 6409 patients included in the study 45% were male and 55% were female. The mean age of the patients was 24.64 years. Smoking habit was reported in 14% of the patients while high glycemic diet (HGD) was seen in half of the cases. Of respondents, 41% knew that acne was due to increased sebum production and blockade of pilosebaceous units whereas 35% had due to excessive cosmetic use. Grade II acne was predominant (47%) and majority of the patients had inflammatory papular acne (51%). The presence of  hyperpigmentation (35%) and scarring (29%) was considered to be a reflection of the severity of the acne. Moisturizers and cleansers were one of the most common supportive measure of acne management. Cleansers were prescribed for 53% of the patients whereas 43% of the patients were prescribed moisturizers. Amongst topical treatment, adapalene and BPO combination (34%) was the most commonly prescribed combination followed by adapalene & clindamycin combination (29%). Monotherapy was not commonly prescribed. Most of the patients were managed with combination therapy. Isotretinoin was most commonly prescribed medication in all grades of acne comprising of 40% of the patients. This study presents the demographic features and clinical characteristics of acne in dermatology office practice in India. Keywords: Acne, Epidemiology, India.

Introduction: The management of dermatophytosis is challenging in India and there are reports of using systemic antifungals at higher doses. But there are multiple reports of increased treatment failures with terbinafine at standard dosage as well, hence we conducted this study to compare efficacy and safety of high dose of terbinafine with itraconazole at standard dose. Topical ciclopirox olamine was used in both arms. Materials and Methods: This was randomized, open label, comparative study where 80 patients with tinea corporis et cruris infection were included. Patients were either prescribed terbinafine 250mg twice a day  or itraconazole 100mg twice a day for 4 weeks. Efficacy was assessed based on complete, clinical and mycological cure rate. Safety was assessed by evaluating adverse events and monitoring liver function of patients. Results: Total 76 patients completed the study with 38 in each group. 81.5% patients achieved complete cure in terbinafine group compared to 76.31% patients in itraconazole group. At the end of six weeks, there was a statistically significant improvement (p value Conclusion: This study shows that the high dose of terbinafine in combination with topical ciclopirox is effective and safe in management of tinea corporis et cruris. Keywords: Terbinafine, Itraconazole corporis et cruris.