Cost-Effectiveness Analysis of Luliconazole vs. Oxiconazole in Tinea Treatment in a Tertiary Care Hospital
Abstract
Objective: To compare the efficacy and cost-effectiveness of luliconazole 1% cream and oxiconazole 1% cream in patients of tinea corporis and cruris receiving oral itraconazole. Methods: This was an observational study conducted between November 2022 to October 2023. In the present study, 106 patients were matched for age, sex, and severity of the disease. They received one of the three treatment groups; topical luliconazole and oral itraconazole were in Group (A), topical oxiconazole and oral itraconazole were in Group (B) while those who received only oral itraconazole were in Group (C). Study groups also received levocetirizine 5 mg orally once daily. At the end of 2nd and 4th week change in clinical parameters was noted and pharmacoeconomic ratio was calculated at the end of 4th week. Results: The change in mean composite scores of the three study groups were compared at the end of 2nd week (group A:50.7%;group;B:48.1%;group C: 46%) and 4th week (group A:89.4%;group B:85.1%;group C:88.4%) and were not statistically significant. (p>0.05) The pharmacoeconomic ratio was least for Group C patients irrespective of severity as compared to Group A and Group B.(p<0.05) Conclusion: The results of the present study suggests that topical luliconazole and oxiconazole are equally efficacious in patients of tinea corporis and cruris receiving oral itraconazole. Patients who received only oral itraconazole the treatment was more cost effective.
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[3] Jerajani H, Janaki C, Kumar S, Phiske M. Comparative assessment of the efficacy and safety of sertaconazole (2%) cream versus terbinafine cream (1%) versus luliconazole (1%) cream in patients with dermatophytoses: a pilot study. Indian J Dermatol. 2013 Jan;58(1):34–8.
[4] Chatterjee D, Ghosh SK, Sen S, Sarkar S, Hazra A, De R. Efficacy and tolerability of topical sertaconazole versus topical terbinafine in localized dermatophytosis: A randomized, observer-blind, parallel group study. Indian J Pharmacol. 2016;48(6):659–64.
[5] Gupta AK, Daigle D. A critical appraisal of once-daily topical luliconazole for the treatment of superficial fungal infections. Infect Drug Resist. 2016;9:1–6.
[6] KD Tripathi. Essential of medical Pharmacology. 8th Edition. 2019. 838–848 p.
[7] Monk BC, Sagatova AA, Hosseini P, Ruma YN, Wilson RK, Keniya MV. Fungal Lanosterol 14α-demethylase: A target for next-generation antifungal design. Biochim Biophys Acta Proteins Proteomics. 2020 Mar;1868(3):140206.
[8] Sahoo AK, Mahajan R. Management of tinea corporis, tinea cruris, and tinea pedis: A comprehensive review. Indian Dermatol Online J. 2016;7(2):77–86.
[9] Inamadar AC, Rengasamy M, Charugulla SN. Treatment approach for superficial dermatophytosis infections and factors contributing for noncompliance to antifungal therapy in India: An epidemiological survey. Clin Dermatol Rev. 2022;6:15–21.
[10] Baveja S, Vashisht D, Kothari R, Venugopal R, Kumar Joshi R. Comparative evaluation of the efficacy of itraconazole with terbinafine cream versus itraconazole with sertaconazole cream in dermatophytosis: A within person pilot study. Med J Armed Forces India. 2023;79(5):526–30.
[11] Shah P, Bhargava S, Chakrabarty S, Damodaran RT, Saikia PK, Shenoy M, et al. Rising burden of superficial fungal infections in India and the role of Clotrimazole for optimal management. IP Indian J Clin Exp Dermatol [Internet]. 2023 Apr 28 [cited 2024 Jul 7];9(1):1–16. Available from: https://ijced.org/article-details/18569
[12] Jartarkar SR, Patil A, Goldust Y, Cockerell CJ, Schwartz RA, Grabbe S, et al. Pathogenesis, Immunology and Management of Dermatophytosis. J Fungi [Internet]. 2021 Dec 31 [cited 2024 Jul 7];8(1):39. Available from: https://www.mdpi.com/2309-608X/8/1/39
[13] Saunders J, Maki K, Koski R, Nybo SE. Tavaborole, Efinaconazole, and Luliconazole: Three New Antimycotic Agents for the Treatment of Dermatophytic Fungi. J Pharm Pract. 2017 Dec;30(6):621–30.
[14] Jerajani HR, Amladi ST, Bongale R, Adepu V, Tendolkar UM, Sentamilselvi G, et al. Evaluation of clinical efficacy and safety of once daily topical administration of 1% oxiconazole cream and lotion in dermatophytosis : an open label, non comparative multicentre study. Indian J Dermatol Venereol Leprol. 2000;66(4):188–92.
[15] Pai V, Ganavalli A, Kikkeri N. Antifungal resistance in dermatology. Indian J Dermatol [Internet]. 2018 [cited 2024 Aug 27];63(5):361. Available from: https://journals.lww.com/10.4103/ijd.IJD_131_17
[16] Stein Gold LF, Rosen T. Using Topical Antifungal Medications: Instructions for patients. Semin Cutan Med Surg. 2016 Mar;35(3 Suppl 3):s60.
[17] Chen S, Ran Y, Dai Y, Lama J, Hu W, Zhang C. Administration of Oral Itraconazole Capsule with Whole Milk Shows Enhanced Efficacy As Supported by Scanning Electron Microscopy in a Child with Tinea Capitis Due to Microsporum canis. Pediatr Dermatol. 2015;32(6):e312-313.
[18] Reich A, Bożek A, Janiszewska K, Szepietowski JC. 12-Item Pruritus Severity Scale: Development and Validation of New Itch Severity Questionnaire. BioMed Res Int. 2017;2017:1–7.
[19] Reich A, Heisig M, Phan N, Taneda K, Takamori K, Takeuchi S, et al. Visual Analogue Scale: Evaluation of the Instrument for the Assessment of Pruritus. Acta Derm Venereol [Internet]. 2012 [cited 2024 Aug 27];92(5):497–501. Available from: https://medicaljournalssweden.se/actadv/article/view/8923
[20] Clinical Review Report: Guselkumab (Tremfya): (Janssen Inc.): Indication: For the treatment of adult patients with moderate-to-severe plaque psoriasis who are candidates for systemic therapy or phototherapy [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2018 Mar. Appendix 5, Validity of Outcome Measures. Available from: https://www.ncbi.nlm.nih.gov/books/NBK534046/.
[21] Bhor U, Pande S. Scoring systems in dermatology. Indian J Dermatol Venereol Leprol. 2006;72(4):315–21.
[22] Thomas J, Das S, Ghate S, Chatterjee M, Teltumde S, Charugulla SN, et al. Effectiveness and safety of eberconazole 1% cream in Indian patients with Tinea corporis and Tinea cruris: a prospective real-world study. Int J Res Dermatol [Internet]. 2020 Dec 24 [cited 2024 Jul 7];7(1):96. Available from: https://www.ijord.com/index.php/ijord/article/view/1197
[23] Torgerson DJ, Campbell MK. Economics notes: cost effectiveness calculations and sample size. BMJ. 2000 Sep 16;321(7262):697.
[24] Jain S, Barambhe M, Jain J, Jajoo U, Pandey N. Prevalence of skin diseases in rural Central India: A community-based, cross-sectional, observational study. J Mahatma Gandhi Inst Med Sci. 2016 Jan;21:111.
[25] Kumar P, Ramachandran S, Das S, Bhattacharya SN, Taneja B. Insights into Changing Dermatophyte Spectrum in India Through Analysis of Cumulative 161,245 Cases Between 1939 and 2021. Mycopathologia. 2023 Jun;188(3):183–202.
[26] Leung AK, Lam JM, Leong KF, Hon KL. Tinea corporis: an updated review. Drugs Context. 2020;9:2020-5–6.
[27] Bhatia A, Kanish B, Badyal DK, Kate P, Choudhary S. Efficacy of oral terbinafine versus itraconazole in treatment of dermatophytic infection of skin - A prospective, randomized comparative study. Indian J Pharmacol. 2019;51(2):116–9.
[28] Rana DK, Shah TS, Rohit MH, Patel NH, Khadela AD, Oza YP, et al. Evaluation of the benefit of the addition of 1% topical luliconazole versus topical bland emollient to the systemic itraconazole therapy for the management of disseminated dermatophytosis: A randomised control trial. Mycoses. 2024 Jan;67(1):e13681.
[29] Islam M, Akhter S, Khondker L, Khan M s, Siddiqua A. Efficacy of Topical 1% Oxiconazole Cream in the Treatment of Dermatophytosis. J Enam Med Coll. 2014 May;4.
[30] Khurana A, Agarwal A, Agrawal D, Panesar S, Ghadlinge M, Sardana K, et al. Effect of Different Itraconazole Dosing Regimens on Cure Rates, Treatment Duration, Safety, and Relapse Rates in Adult Patients With Tinea Corporis/Cruris: A Randomized Clinical Trial. JAMA Dermatol. 2022 Nov 1;158(11):1269.
[31] Koga H, Nanjoh Y, Kaneda H, Yamaguchi H, Tsuboi R. Short-Term Therapy with Luliconazole, a Novel Topical Antifungal Imidazole, in Guinea Pig Models of Tinea Corporis and Tinea Pedis. Antimicrob Agents Chemother. 2012 Jun;56(6):3138–43.
[32] Konch K, Sarmah J. A Comparative Study to Assess the Knowledge and Practices of Homemakers on Food Hygiene at Dhemaji District of Assam, India. Asian J Agric Ext Econ Sociol. 2023 May 26;41(7):230–5.
[33] Yee G, Al Aboud A. Tinea Corporis. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: [Internet]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK544360
[2] Dakhale GN, Gupta AV, Mukhi JI, Kalikar MV. Comparison of efficacy, safety, and cost-effectiveness of sertaconazole and luliconazole cream in patients with dermatophytoses: A prospective, randomized, open-label study. Perspect Clin Res. 2021;12(4):223–8.
[3] Jerajani H, Janaki C, Kumar S, Phiske M. Comparative assessment of the efficacy and safety of sertaconazole (2%) cream versus terbinafine cream (1%) versus luliconazole (1%) cream in patients with dermatophytoses: a pilot study. Indian J Dermatol. 2013 Jan;58(1):34–8.
[4] Chatterjee D, Ghosh SK, Sen S, Sarkar S, Hazra A, De R. Efficacy and tolerability of topical sertaconazole versus topical terbinafine in localized dermatophytosis: A randomized, observer-blind, parallel group study. Indian J Pharmacol. 2016;48(6):659–64.
[5] Gupta AK, Daigle D. A critical appraisal of once-daily topical luliconazole for the treatment of superficial fungal infections. Infect Drug Resist. 2016;9:1–6.
[6] KD Tripathi. Essential of medical Pharmacology. 8th Edition. 2019. 838–848 p.
[7] Monk BC, Sagatova AA, Hosseini P, Ruma YN, Wilson RK, Keniya MV. Fungal Lanosterol 14α-demethylase: A target for next-generation antifungal design. Biochim Biophys Acta Proteins Proteomics. 2020 Mar;1868(3):140206.
[8] Sahoo AK, Mahajan R. Management of tinea corporis, tinea cruris, and tinea pedis: A comprehensive review. Indian Dermatol Online J. 2016;7(2):77–86.
[9] Inamadar AC, Rengasamy M, Charugulla SN. Treatment approach for superficial dermatophytosis infections and factors contributing for noncompliance to antifungal therapy in India: An epidemiological survey. Clin Dermatol Rev. 2022;6:15–21.
[10] Baveja S, Vashisht D, Kothari R, Venugopal R, Kumar Joshi R. Comparative evaluation of the efficacy of itraconazole with terbinafine cream versus itraconazole with sertaconazole cream in dermatophytosis: A within person pilot study. Med J Armed Forces India. 2023;79(5):526–30.
[11] Shah P, Bhargava S, Chakrabarty S, Damodaran RT, Saikia PK, Shenoy M, et al. Rising burden of superficial fungal infections in India and the role of Clotrimazole for optimal management. IP Indian J Clin Exp Dermatol [Internet]. 2023 Apr 28 [cited 2024 Jul 7];9(1):1–16. Available from: https://ijced.org/article-details/18569
[12] Jartarkar SR, Patil A, Goldust Y, Cockerell CJ, Schwartz RA, Grabbe S, et al. Pathogenesis, Immunology and Management of Dermatophytosis. J Fungi [Internet]. 2021 Dec 31 [cited 2024 Jul 7];8(1):39. Available from: https://www.mdpi.com/2309-608X/8/1/39
[13] Saunders J, Maki K, Koski R, Nybo SE. Tavaborole, Efinaconazole, and Luliconazole: Three New Antimycotic Agents for the Treatment of Dermatophytic Fungi. J Pharm Pract. 2017 Dec;30(6):621–30.
[14] Jerajani HR, Amladi ST, Bongale R, Adepu V, Tendolkar UM, Sentamilselvi G, et al. Evaluation of clinical efficacy and safety of once daily topical administration of 1% oxiconazole cream and lotion in dermatophytosis : an open label, non comparative multicentre study. Indian J Dermatol Venereol Leprol. 2000;66(4):188–92.
[15] Pai V, Ganavalli A, Kikkeri N. Antifungal resistance in dermatology. Indian J Dermatol [Internet]. 2018 [cited 2024 Aug 27];63(5):361. Available from: https://journals.lww.com/10.4103/ijd.IJD_131_17
[16] Stein Gold LF, Rosen T. Using Topical Antifungal Medications: Instructions for patients. Semin Cutan Med Surg. 2016 Mar;35(3 Suppl 3):s60.
[17] Chen S, Ran Y, Dai Y, Lama J, Hu W, Zhang C. Administration of Oral Itraconazole Capsule with Whole Milk Shows Enhanced Efficacy As Supported by Scanning Electron Microscopy in a Child with Tinea Capitis Due to Microsporum canis. Pediatr Dermatol. 2015;32(6):e312-313.
[18] Reich A, Bożek A, Janiszewska K, Szepietowski JC. 12-Item Pruritus Severity Scale: Development and Validation of New Itch Severity Questionnaire. BioMed Res Int. 2017;2017:1–7.
[19] Reich A, Heisig M, Phan N, Taneda K, Takamori K, Takeuchi S, et al. Visual Analogue Scale: Evaluation of the Instrument for the Assessment of Pruritus. Acta Derm Venereol [Internet]. 2012 [cited 2024 Aug 27];92(5):497–501. Available from: https://medicaljournalssweden.se/actadv/article/view/8923
[20] Clinical Review Report: Guselkumab (Tremfya): (Janssen Inc.): Indication: For the treatment of adult patients with moderate-to-severe plaque psoriasis who are candidates for systemic therapy or phototherapy [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2018 Mar. Appendix 5, Validity of Outcome Measures. Available from: https://www.ncbi.nlm.nih.gov/books/NBK534046/.
[21] Bhor U, Pande S. Scoring systems in dermatology. Indian J Dermatol Venereol Leprol. 2006;72(4):315–21.
[22] Thomas J, Das S, Ghate S, Chatterjee M, Teltumde S, Charugulla SN, et al. Effectiveness and safety of eberconazole 1% cream in Indian patients with Tinea corporis and Tinea cruris: a prospective real-world study. Int J Res Dermatol [Internet]. 2020 Dec 24 [cited 2024 Jul 7];7(1):96. Available from: https://www.ijord.com/index.php/ijord/article/view/1197
[23] Torgerson DJ, Campbell MK. Economics notes: cost effectiveness calculations and sample size. BMJ. 2000 Sep 16;321(7262):697.
[24] Jain S, Barambhe M, Jain J, Jajoo U, Pandey N. Prevalence of skin diseases in rural Central India: A community-based, cross-sectional, observational study. J Mahatma Gandhi Inst Med Sci. 2016 Jan;21:111.
[25] Kumar P, Ramachandran S, Das S, Bhattacharya SN, Taneja B. Insights into Changing Dermatophyte Spectrum in India Through Analysis of Cumulative 161,245 Cases Between 1939 and 2021. Mycopathologia. 2023 Jun;188(3):183–202.
[26] Leung AK, Lam JM, Leong KF, Hon KL. Tinea corporis: an updated review. Drugs Context. 2020;9:2020-5–6.
[27] Bhatia A, Kanish B, Badyal DK, Kate P, Choudhary S. Efficacy of oral terbinafine versus itraconazole in treatment of dermatophytic infection of skin - A prospective, randomized comparative study. Indian J Pharmacol. 2019;51(2):116–9.
[28] Rana DK, Shah TS, Rohit MH, Patel NH, Khadela AD, Oza YP, et al. Evaluation of the benefit of the addition of 1% topical luliconazole versus topical bland emollient to the systemic itraconazole therapy for the management of disseminated dermatophytosis: A randomised control trial. Mycoses. 2024 Jan;67(1):e13681.
[29] Islam M, Akhter S, Khondker L, Khan M s, Siddiqua A. Efficacy of Topical 1% Oxiconazole Cream in the Treatment of Dermatophytosis. J Enam Med Coll. 2014 May;4.
[30] Khurana A, Agarwal A, Agrawal D, Panesar S, Ghadlinge M, Sardana K, et al. Effect of Different Itraconazole Dosing Regimens on Cure Rates, Treatment Duration, Safety, and Relapse Rates in Adult Patients With Tinea Corporis/Cruris: A Randomized Clinical Trial. JAMA Dermatol. 2022 Nov 1;158(11):1269.
[31] Koga H, Nanjoh Y, Kaneda H, Yamaguchi H, Tsuboi R. Short-Term Therapy with Luliconazole, a Novel Topical Antifungal Imidazole, in Guinea Pig Models of Tinea Corporis and Tinea Pedis. Antimicrob Agents Chemother. 2012 Jun;56(6):3138–43.
[32] Konch K, Sarmah J. A Comparative Study to Assess the Knowledge and Practices of Homemakers on Food Hygiene at Dhemaji District of Assam, India. Asian J Agric Ext Econ Sociol. 2023 May 26;41(7):230–5.
[33] Yee G, Al Aboud A. Tinea Corporis. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: [Internet]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK544360
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| Issue | Vol 11 No 01 (2025) | |
| Section | Original Article(s) | |
| Keywords | ||
| Keywords: Dermatophytosis Composite score Direct cost Pharmacoeconomic ratio Manual labourers. | ||
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How to Cite
1.
Sawant A, Chincholkar A, Pentewar G. Cost-Effectiveness Analysis of Luliconazole vs. Oxiconazole in Tinea Treatment in a Tertiary Care Hospital. JPPM. 2025;11(01):14-23.
