Evidence map›Paper›PMID 34219433›Full record

ReviewIndian journal of dermatology, venereology and leprology

The unprecedented epidemic-like scenario of dermatophytosis in India: III. Antifungal resistance and treatment options.

Shyam B Verma, Saumya Panda, Pietro Nenoff, Archana Singal, Shivprakash M Rudramurthy, Silke Uhrlass, Anupam Das, Kavita Bisherwal, Dipika Shaw, Resham Vasani

Open access · diamondAbstract readReview
PubMed Publisher
In one paragraph

Review in Indian journal of dermatology, venereology and leprology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed, 1 pooled it
5.1field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

26 citing papers in PubMed, 1 synthesis or guideline pooled it, 49 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. The emergence of superficial dermatophytosis due toJournal of clinical microbiology · 2026
    Article
  5. Article
  6. Trichophyton indotineae: Epidemiology, antifungal resistance and antifungal stewardship strategies.Journal of the European Academy of Dermatology and Venereology : JEADV · 2026
    Review
  7. Article
  8. Terbinafine Resistance inAntibiotics (Basel, Switzerland) · 2025
    Review
  9. Article
  10. Review
  11. Review
  12. Article
  13. [Dermatomycoses: topical and systemic antifungal treatment].Dermatologie (Heidelberg, Germany) · 2024
    Review
  14. Article
  15. Article
  16. Review
  17. Article
  18. Article
  19. Review
  20. Journal of fungi (Basel, Switzerland) · 2022
    Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 1 country.

Shyam B VermaNirvan Skin Clinic, Vadodara, Gujarat, India.
Saumya PandaDepartment of Dermatology, Belle Vue Clinic, Kolkata, West Bengal, India, India.
Pietro NenoffDepartment of Dermatology and Laboratory Medicine, Laboratory for Medical Microbiology, Moelbis, Germany.
Archana SingalDepartment of Dermatology and STD, University College of Medical Sciences and GTB Hospital, Delhi, India.
Shivprakash M RudramurthyDepartment of Medical Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Silke UhrlassDepartment of Dermatology and Laboratory Medicine, Laboratory for Medical Microbiology, Moelbis, Germany.
Anupam DasDepartment of Dermatology, KPC Medical College and Hospital, Kolkata, West Bengal, India.
Kavita BisherwalDepartment of Dermatology, Venereology and Leprosy, Lady Hardinge Medical College and SSK Hospital, Delhi.
Dipika ShawDepartment of Medical Microbiology, PGI, Chandigarh, India.
Resham VasaniDepartment of Dermatology, Bhojani Clinic, Mumbai, Maharashtra, India.
Post Graduate Institute of Medical Education and Research · INGuru Teg Bahadur Hospital · INKPC Medical College and Hospital · INLady Hardinge Medical College · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

One of the canonical features of the current outbreak of dermatophytosis in India is its unresponsiveness to treatment in majority of cases. Though there appears to be discordance between in vivo and in vitro resistance, demonstration of in vitro resistance of dermatophytes to antifungals by antifungal susceptibility testing is essential as it may help in appropriate management. The practical problem in the interpretation of antifungal susceptibility testing is the absence of clinical breakpoints and epidemiologic cutoff values. In their absence, evaluation of the upper limit of a minimal inhibitory concentration of wild type isolates may be beneficial for managing dermatophytosis and monitoring the emergence of isolates with reduced susceptibility. In the current scenario, most of the cases are unresponsive to standard dosages and duration of treatment recommended until now. This has resulted in many ex-cathedra modalities of treatment that are being pursued without any evidence. There is an urgent need to carry out methodical research to develop an evidence base to formulate a rational management approach in the current scenario.

Indexed as

Drug Resistance, FungalAdaptation, PhysiologicalAntifungal AgentsBiofilmsEpidemicsFungiHumansIndiaMicrobial Sensitivity TestsMutationSqualene MonooxygenaseTineaAntifungal AgentsSqualene MonooxygenaseAntifungal agentsantifungal susceptibility testingclinical breakpointsepidemiologic cutoff valuesthe upper limit of minimal inhibitory concentration of wild type isolates

Identifiers

PMID34219433
OpenAlexW3176413562

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.