TCA as an effective augmentation therapy in case of resistant and recurrent tinea cruris & corporis

Background: The widespread resistance and recurrent cases of dermatophytosis have become a real challenge. Aim and Objectives: To study the efficacy of augmented therapy against recurrent dermatophytosis by trichloroacetic acid peeling added to systemic itraconazole. Method: 13 Egyptian patients (7 males and 6 females) having dermatophytosis were enrolled in the study. Trichloroacetic acid 30% was applied over the lesions weekly for 5 successive weeks with systemic itraconazole 400 mg daily for 2 weeks and then 100 mg daily for one month; thereafter, patients were followed up every 2 weeks for 6 weeks. Results: Of the 13 patients, 2 patients didn’t complete the study; of the remaining 11 patients, 72% of patients (8 patients) were cured 2 weeks after the last application, while of the remaining 3, 2 had recurrence after initial response (18%), and 1 patient was considered resistant by showing minimal response (9%). These findings indicate that 5 weeks ’ treatment with topical TCA 30% application is a good augmentation treatment with systemic itraconazole in resistant and recurrent dermatophyte infection. Limitations: A relatively small sample size and lack of fungal strain identification are the shortcomings of this study. Conclusion: Trichloroacetic acid peel is a cheap, available, and useful option as an adjuvant in the treatment of resistant & recurrent dermatophytic infection.