Résumé
Background: Tinea corporis is a common superficial dermatophytosis seen in tropical countries. This study was done to compare the efficacy and safety of topical antifungal agents, terbinafine versus sertaconazole in the treatment of tinea corporis. Methods: This study was conducted in Babuji Hospital and Chigateri Government Hospital, Davangere. A total of 60 (n=60) patients were included and divided into two groups of 30 patients each in the study. 1st group - received topical 1% terbinafine hydrochloride and 2nd group - received 2% sertaconazole cream. Patients were advised to apply cream twice daily for 4 weeks. Improvement in clinical parameters like erythema, scaling, itching, and potassium hydroxide (KOH) mount were taken for assessing the efficacy of drugs. They were followed-up at the end of 2, 4, and 6 weeks to assess the improvement of the condition. Complete cure rate was defined as mycological cure with a complete absence of clinical signs and symptoms. For safety data of both drugs presence of any local side effects (like stinging sensation, swelling and increased erythema) were analyzed in both groups. Statistical analysis was done using students paired t-test and unpaired t-test. Results: When two groups were compared at the end of 2 weeks, complete cure rate for terbinafine was 80% as compared to 63.3% for sertaconazole (p<0.003). However, at the end of 4 weeks, sertaconazole was as effective as terbinafine and statistically non-significant (p>0.05) results were obtained. KOH mount was negative in both groups at the end of 2nd week. Local side effects like erythema, swelling, stinging sensation were not noticed during the study in both the groups. Conclusion: From this study, it was shown that 2% sertaconazole cream was as effective as 1% terbinafine cream, though 1% terbinafine had higher rates of complete cure at the end of 2 weeks as compared to sertaconazole.
Résumé
Introduction: Corneal infection of fungal etiology is very common and represents 30% to 40% of all cases of culture positive infectious keratitis. Hence an understanding of the epidemiological features is important in rapid recognition, timely institution of therapy, optimal management and prevention of this disease entity. Objectives: To isolate the specific fungal agents causing keratitis. To determine the risk factors and other epidemiological characteristics of infectious keratitis. To evaluate the importance of direct microscopy in the isolation of etiological agents and institution of therapy. Material Methods: Corneal scrapings were collected under strict aseptic conditions from each patient. The scrapings were subjected to direct microscopy using 10% Potassium Hydroxide (10% KOH), fungal culture and identification by standard microbiological techniques. Results & Conclusions: Fungal isolates were obtained in 30 out of 100 samples. The predominant fungal isolate was Fusarium spp. (30%), followed by Aspergillus spp. (26.66%). Corneal ulcers showed a higher prevalence in the later age groups (31-70 yr), representing a total of 89.99% of the fungal isolates. Male preponderance was seen, with 70% of the fungal ulcers occurring in males. 93.33% of the ulcers occurred among the lower socio economic group and 80% in the rural areas (villages). Agricultural labourers contributed to 63.33% of the corneal ulcers, and peak incidence of corneal ulceration was seen during the monsoon season- 43.33%. History of corneal trauma (83.33%), with vegetative matter (68%), was the most common predisposing factor noted. 10% KOH mount was positive in 28 out of 30 fungal ulcers- 93.33% sensitivity.