Dr. Abhiram, a consultant dermatologist, discusses the management of resistant and recurrent dermatophytosis—a common clinical challenge in India, particularly when initial single-drug therapy fails. Dr. Abhiram explains how the increasing burden of chronic and extensive fungal infections has made it necessary to consider combination antifungal regimens to improve outcomes and reduce relapse rates. He highlights that combination therapy—often involving two systemic antifungals such as itraconazole with fluconazole, or a systemic agent paired with a topical formulation—is specifically reserved for patients who do not respond to monotherapy or who present with complex scenarios like family transmission or widespread disease.
Importantly, Dr. Abhiram emphasizes that successful management depends not only on choosing the right evidence-based regimen but also on essential supportive measures such as proper decontamination, withdrawal of steroid misuse, and ensuring strict adherence to treatment.
