Efficacy and Safety of Oral Itraconazole vs Oral Itraconazole Plus Oral Isotretinoin in Treatment of Chronic Recurrent Dermatophytosis

Objective: To compare the efficacy and safety of oral itraconazole alone versus oral itraconazole in combination with oral isotretinoin in the treatment of chronic recurrent dermatophytosis. Methodology: This quasi-experimental study was conducted in the Department of Dermatology, Services Hospital, Lahore, over a duration of one year from January to December, 2025, after institutional ethical approval. Written informed consent was obtained, and a total of 125 patients with recurrent tinea cruris and/or tinea corporis were enrolled using a non-probability consecutive sampling technique. Patients were allocated into two groups: group A (n=61) received oral itraconazole alone, while group B (n=64) received oral itraconazole in combination with oral isotretinoin for one month. Patients were followed weekly during the treatment period to assess clinical cure and adverse effects. Mycological cure was assessed at the end of one month of treatment, and patients were then followed monthly for three months posttreatment to evaluate relapse. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) version 26. Results: The mean age of our study participants was 33.95±7.59 years. This study found no statistically significant difference in clinical and mycological cure at treatment completion between the groups (p=0.06). However, relapse was significantly more frequent in group A (55.7%) compared to the group B (34.4%) (p=0.013). Group B experienced a significantly higher frequency of adverse effects, particularly cheilitis and lip dryness (p <0.001). Conclusion: There was no significant difference in initial clinical or mycological cure rates between the groups. However, group B receiving combination therapy significantly reduced relapse rates but was associated with a higher frequency of adverse effects in the treatment of chronic recurrent dermatophytosis.