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Dermatophytosis is one of the leading causes of visits to the dermatology department, especially in India, where the hot and humid climate favours fungal acquisition and perpetuation. Usual modalities of treatment include the use of either oral or topical antifungals or a combination of both, depending on the severity and extent of infection as well as the type of causative organism. But recently, steroid-modified dermatophytosis, an iatrogenically perpetuated dermatophytosis caused by the indiscriminate use of topical corticosteroids has emerged as a troublesome epidemic. We planned a cost-of-illness analysis of superficial dermatophytosis comparing the direct healthcare costs in steroid-naive and steroid-modified dermatophytosis. In our study, the average total cost of treatment for steroid-naive and steroid-modified dermatophytosis was found to be rupees (Rs) 2172.42 and Rs 3770.61 respectively, meaning that the cost for patients who used topical steroids is an additional 40% on average for treatment, when compared with the cost for patients who are steroid naive. The need for more consultations, investigations (relating to atypical presentation) and extended duration of treatment with higher-grade antifungals were found to contribute to the increased financial burden in steroid-modified dermatophytosis. [ABSTRACT FROM AUTHOR]

The various types of steroid preparations seen in our patient cohort were administered by unqualified medical professionals primarily for the patient's cutaneous disease, rather than for any suggestion of an underlying medical condition for which the steroid use could be justified. Clinical examination and biochemical derangement in the hypothalamic-pituitary axis were suggestive of iatrogenic hypercorticolism in 4 of 17 patients (23.5%); we referred these cases (Patients 12, 13, 15 and 17) to an endocrinologist for specialized management. A pilot study to evaluate the patient adherence to antifungal therapy in dermatophytosis: a possible contributory factor to the current epidemic-like situation in India. [Extracted from the article]

A pilot study to evaluate the patient adherence to antifungal therapy in dermatophytosis: a possible contributory factor to the current epidemic-like situation in India Patients (37%) with localized dermatophytosis had higher adherence levels than those with disseminated disease (25%); 54% of patients with disseminated dermatophytosis had low adherence, and the difference was statistically significant ( SP 2 sp I P i = 0.048). Of the 236 patients prescribed both oral and topical antifungals, mean adherence scores were 6.41 for topical and 6.82 for oral antifungal drugs; the score was significantly higher for oral antifungals, and the difference was statistically significant (paired I t i -test, I P i < 0.001). [Extracted from the article]