<b>Effectiveness of oral Itraconazole compared to Itraconazole Plus Isotretinoin for the Management of Superficial Dermatophytosis</b>

Background Superficial dermatophytosis is a recurrent fungal infection affecting keratinized tissues, including the nails, skin, and hair. Recurrence and relapse of the disease remain major concerns despite advancements in antifungal treatment. Objective To examine the safety and effectiveness of oral itraconazole with isotretinoin therapy versus itraconazole monotherapy in patients with superficial dermatophytosis. Methods One hundred and twenty individuals with KOH-positive superficial dermatophytosis participated in a randomized clinical study. Group A received oral isotretinoin (20 mg once daily) along with oral itraconazole (100 mg twice daily) for eight weeks, whereas Group B received oral itraconazole (100 mg twice daily) alone. A 0-3 scale was used to assess the clinical severity of erythema, scaling, and pruritus. Liver function tests and lipid profiles were monitored at baseline and at 4-week intervals. Results After eight weeks treatments both groups showed considerable improvement in erythema, scaling, and pruritus (P<.001). Mean erythema scores decreased from 2.98±0.13 to 0.20±0.52 in Group A and from 2.92±0.28 to 0.25±0.43 in Group B, representing improvements of 93.3% and 91.4%, respectively. No statistically significant intergroup differences were observed. The side effects were minimal and self-limiting. Conclusion Although the combination of itraconazole and isotretinoin was well tolerated and safe, the outcomes were not statistically superior to those of itraconazole monotherapy. However, in severe or recurrent cases, isotretinoin may serve as a useful adjuvant by improving fungal clearance and increasing keratinocyte turnover.