Evaluating the Efficacy and Safety of Voriconazole in the Treatment of Dermatophyte Infections: A Cross-sectional Observational Study

Abstract

Background: Dermatophyte infections are prevalent fungal conditions affecting the skin, hair, and nails, often leading to discomfort and potential complications if untreated. Voriconazole, a triazole antifungal, is effective against various fungal pathogens but its role in treating dermatophyte infections remains under-researched. Objective: This study aimed to evaluate both the efficacy and safety of voriconazole in treating dermatophyte infections. Methods: This cross-sectional and observational study took place at the Community Based Medical College Hospital, Bangladesh, from January 2023 to January 2024. A total of 163 dermatophyte patients were recruited based on the researched simple clinical protocol, which was based on assessing dermatological features, lesion morphology, age of onset, and distribution sites. Adult patients received oral voriconazole 200 mg twice daily for four weeks, and response to treatment was assessed by complete clearance of lesions and repigmentation or return to normal skin color. Results: Most participants were 35 years or younger (53.4%) and female (63.2%). In most cases (68.7%), lesions lasted between 6 months and 1 year. At baseline, 74.8% were classified as having severe conditions, while 20.2% experienced moderate severity. As a result, 91% of participants were fully cured, and 9% were moderately cured. Rash, visual disturbances, nausea, vomiting, and headache were observed in some cases as side effects. Conclusion: Although there is strong evidence portraying the effectiveness of voriconazole for the management of dermatophytes, the study has some shortcomings, including a small sample size, no control group, and a shorter follow-up period. More work should be directed towards the publication of large sample-sized, randomized controlled trials comparing voriconazole with other systemic antifungal agents, the identification of patterns of resistance over a longer time period, and research on a more diverse population.