Superficial mycoses are the commonest fungal infections of humans, and mostly caused by keratinophilic fungi called as dermatophytes. Dermatophytes use keratin as a nutrient during skin, hair and nail infections. Based on the formation and morphology of their conidia, which are the structures of their asexual reproduction, they are classified into three genera, Trichophyton, Microsporum and Epidermophyton. So far, about 30 species of dermatophytes have been identified as human pathogens.

Dermatophytes infect host surfaces containing keratin, including skin, hair, and nails. Both climate and lifestyle contribute to the prevalence of dermatophyte infections. Tropical climates and overcrowding predispose population to dermatophyte infections. Increased urbanization, including the use of occlusive footwear, tight fashioned clothes, community showers and participation in sports, has also been linked to higher prevalence.

Dermatophytes are transmitted by direct contact with infected animals and humans or by indirect contact with contaminated fomites. Typical skin lesions of dermatophytes are annular, erythematous and pruritic patches/plaques which may be mild or severe depending upon the immunologic status of the host. Dermatophytoses occur as a result of direct invasion of the fungus or hypersensitivity reactions to the microorganism and/ or its metabolic products. It is a common cutaneous morbidity as a result of severe itching and social impairment.

  Over past few years, antifungal resistance has emerged due to irrational use of antifungal agents in cutaneous mycoses. Rampant use of corticosteroids containing topical polycombinations peculiar to India may be contributing to this fast growing menance of chronic/recurrent dermatophytosis and “antifungal drug resistance” in tis country particularly. The condition can be treated by local or systemic antifungal therapy depending on the site and severity of the lesions. Some studies around the world are also noticing resistance to common antifungal drugs used for the treatment of such dermatophytic infections. The incidences of relapse and recalcitrant cases are increasing in spite of therapy with complete course of antifungal agents resulting in large pool of recurrent dermatophytoses in the community.

Recurrent dermatophytoses refers to persistent dermatophytoses that run a chronic course with episodes of remission and exacerbation. These patients are potential source of infection not only to their family members but also to the public, thus posing a financial and public health problem. There are various proposed causes which might contribute to chronicity/recurrence. These include antifungal drug resistance, poor hygiene, intra-familial fungal infections and host factors such as immuno-compromised status, diabetes mellitus, atopy and intake of systemic steroids. The problem of recurrence of superficial dermatophytes causes significant distress to the patients socially, emotionally and financially.

Study form north India showed non-responders to gold standard drug griseofulvin among the tinea     capitis patients. In 2002, Mukherjee PK et al found  Trichophyton rubrum strain exhibiting primary resistance to terbinafine. In study conducted by Sarifakioglu E et al (2007) on 100 isolates of onychomycosis, they found terbinafine has lowest  minimum inhibitory concenteration (MIC) followed by itraconazole and fluconazole showed greatest variation in MIC.  In a study conducted by Klafke GB et al (2014) on 100 isolates of onychomycosis they found high MIC value for Fluconazole and Itraconazole in 66.7%  and 25% of isolates of T.rubrum respectively.⁷ In one of the study, it was found that recurrent dermatophytoses was more frequent in low socioeconomic group and tinea corporis and tinea cruris were found to be the most clinical forms associated with chronicity.