ASSESSING THE EFFICACY OF 30 PERCENT SALICYLIC ACID PEEL WITH 1 PERCENT TOPICAL LULICONAZOLE FOR TREATMENT OF DERMATOPHYTOSIS A RANDOMISED CONTROL TRIAL IN CHENGALPATTU TAMilNADU INDIA

Dermatophytosis are superficial fungal infections by three species of fungi  Microsporum, Trichophyton, Epidermophyton. Diagnosis is usually based on history and clinical appearance plus direct microscopy of a potassium hydroxide(KOH) preparation. Culture or histologic examination is rarely required for diagnosis.

In India  the disease  burden of dermatophytosis  ranges from 36.6 % to 78.4 %  (Shaikh Naseem et al.,2023)

Most anti fungal drugs target ergosterol which is unique to the fungal cell wall and absent in mammalian cells. A single molecule alters target by natural selection ,Irrational use of combination of anti-fungal drugs with topical steroid usage   causes   increased in resistance for anti fungal treatments ,Finding the most effective and readily accessible approach remains crucial.

Salicylic acid is a member of group of compound known as beta hydroxy acids, It is a keratolytic agent,  Which desquamates stratum corneum along with keratinophyllic dermatophytes which resides there.

The azole group of anti fungal medication have been extensively employed for treatment of dermatophytosis, The major challenges and problem in dermatophytosis treatment will be anti fungal resistant.

The study has the potential to provide valuable insight to overcome the problem of topical antifungal resistance by replacing with 30% salicylic acid for the treatment of dermatophytosis,

Application of 30% salicylic acid in Dermatology OPD twice a week will help to overcome the patient’s non-compliance and inconsistent application of anti fungal, thus improving the adherence of patient towards treatment

Comparing the efficacy and safety of 30% salicylic acid with Topical luliconazole as an adjuvant therapy in achieving mycological and clinical cure.

Primary outcome variable

1. Mycological cure : Absence of fungal hyphae on KOH Mount when visualise under microscope

2. Clinical cure : Complete resolution of all the clinical symptoms (itching, scaling, erythema, no new lesions )

Secondary outcome variable

1. Adverse effects : Measures the occurrence of any side-effects with the treatment

2. Quality of life : Assessed by DLQI questionnaire

Patient attending dermatology OPD in Karpaga Vinayaka Institute of medical sciences and research Centre, Of either gender and above 18 years of age. Clinically diagnosed with dermatophytosis, Relevant history will be taken regarding age, sex, duration of complaints, treatment history, comorbidities and family history. Patient with KOH mount positive are enrolled in this study ,Patient were randomly allocated into two groups by chit method (simple block computerised randomisation),

Two groups- group A and group B are divided ,

Group A will be given topical luliconazole with oral itraconazole.

Group B will be given 30% salicylic acid with oral itraconazole.

Follow-up for once every two weeks for eight weeks .

30% salicylic acid will be given at week 0, week 2, week 4 , week 6 for Group B.

The KOH Mount is performed at baseline , fourth week ,eighth weeks of treatment.

Dermatology life quality index questionnaire and Total symptom score will be assessed at baseline, four and eighth weeks of treatment.

Consent will be taken from the patient for using information