The menace of hyperkeratotic tinea infection: A new therapeutic combination on horizon

Background: Hyperkeratinization and changes in skin pH play very important role in pathogenesis of tinea infections resulting in treatment failure in multiple patients. The objective of the current consensus was to provide an experience-driven approach regarding the management of hyperkeratotic tinea infection with combination of topical antifungal and keratolytic agents. Materials and Methods: 9 experts in the field of dermatology participated in digital meeting to discuss the role of combination of topical antifungal and keratolytic agent based on prevalidated questionnaire consisting of 18 questions. Questions were graded on a scale of 1 to 10 (1 being not recommended and 10 being strongly recommended). Results: During the meeting panellists discussed regarding the pathophysiological aspects of hyperkeratotic tinea infection, impact of hyperkeratinization or scaling and changes in skin pH on management of patients with tinea infection, ideal topical antifungal and keratolytic agent and the rationale for combination, frequency, duration and method of application, initiation of therapy, safety of combination and precautions to be taken during treatment period. After the end of meeting total 18 recommendations were made based on a thorough discussion, available evidence and practical experience of the experts. Conclusion: This consensus will help in management of patients with hyperkeratotic tinea infection and will improve the treatment outcomes in these patients. Keywords: Hyperkeratotic tinea infections, Keratolytic, Combination, Luliconazole, Salicylic acid.