Clinical Research Directory

In Vitro Susceptibility of Dermatophytes to Terbinafine and Itraconazole: MIC Distributions and Elevated-MIC Isolates in Faisalabad, Pakistan

Dermatophyte infections of the skin, hair and nails are common in Pakistan, and treatment failure with standard antifungal drugs is increasingly reported. Local laboratory data on how dermatophytes respond to terbinafine and itraconazole are limited. This study will collect skin scrapings, hair or nail samples from consecutive dermatology outpatients with KOH-confirmed dermatophytosis, grow the fungi in culture, and test each isolate against terbinafine and itraconazole using the standard CLSI M38 broth microdilution method. The study will report the proportion of Trichophyton isolates with an elevated terbinafine minimum inhibitory concentration (MIC), the MIC distributions of both drugs, and the species involved, and will explore whether elevated terbinafine MICs are associated with clinical features such as disease duration, previous antifungal use and topical corticosteroid use. Participation does not change treatment; the study only tests samples in the laboratory.

A Pilot Study to Evaluate the Therapeutic Efficacy of Intra-Lesional Immunotherapy in Patients Aged 10-60 Years With Recalcitrant Tinea Cruris and Corporis

This pilot study will test intra-lesional immunotherapy (MMR vaccine) injections as a treatment for recalcitrant tinea cruris and corporis in patients aged 10-60 years who have not improved with standard antifungal treatments. \*Eligibility: Participants must have recalcitrant tinea, defined as: * Rapid progression or large areas of skin affected, * Infection in multiple family members, especially females and children * Rapid relapse after prior treatment * Suspected resistant T. indotineae (based on travel history or contact with affected individuals from high-prevalence regions) * Failure of at least 2 courses of systemic antifungal therapy in the past 3 months Treatment: Patients will receive intra-lesional MMR vaccine injections into the active borders of affected lesions every 2 weeks for up to 6 weeks. If partial improvement occurs but complete clearance is not achieved, the course may be repeated for another 6 weeks. Pulse itraconazole will be given during the first 2 weeks. Monitoring: At each study visit, clinicians will assess the extent of affected skin and monitor symptoms particularly itching. Safety will be closely observed, including injection-site reactions, fever, initial flare of lesions, and any rare serious allergic reactions. Goal: To evaluate the safety and effectiveness of intra-lesional MMR immunotherapy for patients with tinea that has been difficult to treat.