Dual therapy with minocycline and itraconazole as a new treatment option for recurrent dermatophytosis

Introduction
Recurrent dermatophytosis presents a clinical dilemma for patients and dermatologists. These cases often have a chronic and inflammatory nature and are resistant to commonly used antifungal drugs. Numerous treatment options have been proposed to address this problem.

Aim
This study aimed to evaluate the effectiveness of combining minocycline with itraconazole in the treatment of recurrent widespread dermatophytosis.

Material and methods
A prospective clinical trial was conducted on 86 patients with recurrent extensive dermatophytosis. All patients received a daily dose of 100 mg itraconazole and 80 mg minocycline orally for two–six/2–6 weeks. The patients were closely monitored every 2 weeks until they achieved a complete cure. They were followed up for 3 consecutive months and instructed to return if they experienced any signs of recurrence.

Results
This study included 86 patients aged between 18 and 65 years with recurrent dermatophytosis. Trichophyton rubrum was the most common species, accounting for 61 (70.9%) cases. Nearly half of the patients (41, 47.6%) had infections at more than one site. The study revealed that thirty-one (36%) of the treated patients were cured after 2 weeks, 35 (40.7%) patients showed total recovery after 4 weeks, and the remaining 20 (23.3%) patients achieved complete recovery after 6 weeks. The cure rate was 100% within 2–6 weeks and the recurrence rate was 3.5%.

Conclusions
Trichophyton rubrum is the predominant causative agent of recurrent dermatophytosis. Minocycline, when used with itraconazole, has proven to be an effective, safe, and promising treatment for recurring and extensive dermatophytosis.