Comparison between oral voriconazole and terbinafine in treatment of relapse or resistant tinea corporis and cruris

Background: Dermatophytosis is a worldwide health-related problem. A number of antifungal agents have been introduced to treat dermatophytosis. Once it was very easy to treat with either topical or systemic antifungal agents but now become a challenge for dermatologists because of increasing resistance against conventional antifungals fluconazole, itraconazole, and terbinafine with standard dosages and duration for the last few years. So, search for an effective new oral antifungal agent now become essential.
Materials & methods: This cross-sectional comparative study was conducted in Department of Dermatology and Venereology, Dhaka Medical College Hospital, Dhaka and Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh to observe the efficacy of voriconazole and oral terbinafine in the treatment of relapse or resistant tinea corporis & cruris. Out of total tinea infected patients selected only those patients who didn’t respond to routine treatment, relapsed soon after stoppage of treatment or those having persistent dermatophytic infection. A total number of 100 patients was selected and they were allocated into two groups (group-A and group-B), each of which included 50 patients. Group A was received Voriconazole (200 mg) twice daily for 4 weeks and group B patients given double dose of Terbinafine (250 mg) twice daily for 4 weeks. Patients were followed up on 2nd week (1st follow up) and 4th week (2nd follow up) to see clinical improvement and adverse effects. 
Results: Mean age was found 32.4±5.7 years in group A and 31.9±5.9 years in group B. Out of 50 cases, 54.0% cases were male in group A and 56.0% in group B. Large number of respondents hailing from urban area. Socioeconomically middle class (42.0%) comprising the major percentage of the patients. Majority of patients (52%) had a duration of tinea between 6 months to < 2 years (27%). All patient (100%) had tinea corporis and tinea cruris was present in 72.0% patients. Complete cure was seen in 82% of patient in group A and 64.0% patients in group B. The difference was statistically significant, means voriconazole is highly effective antifungal agent than terbinafine. 
Conclusions: Present study concluded that voriconazole is a highly effective and safe oral antifungal agent that can be used in the treatment of relapse and resistant cases of dermatophytosis.