Dermatophytic infections of the skin and appendages are commonplace in occurrence. Pathogenesis is a complex interplay of agent (dermatophytes), host (inherent host defense and host immune response), and the environment. Infection management has evolved as a crucial public health issue, due to the increased incidence of recurrent, recalcitrant, or extensive infections. Current years have witnessed a substantial rise in the incidence of chronic infections which have been challenging to treat. 

Topical antifungals in dermatophytic infections employ imidazoles, triazoles, allylamines, and others like amolorfine 0.25%, amphotericin B (1 mg) 0.1%, ciclopiroxolamine 1%. Systemic antifungals like fluconazole, griseofulvin, itraconazole, and terbinafine can be employed in dermatophytic infections like tinea capitis, tinea corporis/cruris, tinea unguium, and tinea pedis.

Successful management of dermatophytosis has increasingly become challenging due to the changing epidemiological factors and the emergence of drug-resistant organisms. The suitable dose and duration of the drug in a compliant patient help to accomplish a successful mycological cure. Along with pharmacological therapy, general measures and lifestyle changes also play a crucial role in controlling recurrences. Improved diagnostic tests and novel immunomodulatory therapy signify advances in disease management.

Source: Jartarkar SR, Patil A, Goldust Y, et al. Pathogenesis, immunology and management of dermatophytosis. J Fungi (Basel). 2021;8(1):39.