IADVL SIG Recalcitrant Dermatophytosis Position Statement on Super Bioavailable Itraconazole.

Itraconazole (ITZ) has been the mainstay of oral antifungal treatment for the current epidemic of recalcitrant dermatophytosis (RD) in India. Recently, a newer formulation of ITZ, super bioavailable itraconazole (SUBA-ITZ), is made available in the market by many pharmaceutical companies. It is important for dermatologists to understand the pharmacokinetic properties of SUBA-ITZ vis-a-vis conventional pellet formulation to use it effectively and safely. Indian Association of Dermatologists, Venereologists and Leprologists (IADVL) has established a special interest group for recalcitrant dermatophytosis (SIG-RD) to strengthen research, continuing medical education, and industry collaboration on the subject. This position statement on SUBA-ITZ by SIG-RD is an attempt to address current pieces of evidence and the position of this new formulation in the management of RD.

Comparative Efficacy Of 35% Glycolic Acid Peel vs. Jessner Peel as an Adjuvant to Topical Triple Combination (2% Hydroquinone, 0.025% Tretinoin, 0.01% Fluocinolone Acetonide) Therapy in Melasma Females Cases.

Melasma is a common, acquired, circumscribed hypermelanosis of sun-exposed skin. It presents as symmetric, hyperpigmented macules having irregular, serrated, and geographic borders. Compare the efficacy of 35% gycolic acid (GA) peel vs. Jessner peel (JP) as an adjuvant to topical triple combination (2% Hydroquinone, 0.025% tretinoin, 0.01% Fluocinolone acetonide) therapy in Melasma in females. Sixty cases of Melasma attending Skin-VD OPD, Baroda Medical College from September 1, 2016 to July 30,/2017 were enrolled. Among them, 12% cases had history of menstrual irregularity, 5% cases had past history of oral contraceptive (OC) pill intake, and 10% cases had history of working outdoors. Most common pattern of melasma was centrofacial 32 cases (53%) which was followed by malar pattern in 27 cases (47%) and mandibular pattern in one case (2%). Fifty cases who completed study were evaluated for comparative efficacy of GA peel versus JP as an adjuvant to topical triple combination therapy. Average reduction in Melasma Area and Severity Index (MASI) score in cases treated with GA peel group was 58.56% with Jessner peel group was 59.12%. In GA peel group, 84% cases had moderate to good improvement, whereas in JP group 92% cases had moderate to good improvement. According to present study, safety and efficacy profile of 35% GA peel vs. JP was almost same. Both can be used as an adjuvant to topical triple combination therapy of 2% hydroquinone, 0.025% tretinoin, and 0.01% fluocinolone acetonide in females suffering from melasma. We recommend that it will be safer for the pregnant women to get the GA peel rather than the treatment containing hydroquinone and tretinoin since the activity/performance is very similar.