Steroid-Modified Dermatophytosis: A Clinical and Diagnostic Challenge.

Dermatophytosis represents one of the most prevalent superficial fungal infections affecting the skin, hair, and nails worldwide. In recent years, the widespread and often indiscriminate use of topical corticosteroids has been frequently combined with antifungal and antibacterial agents. This narrative review explores the impact of corticosteroid misuse on dermatophytosis, focusing on changes in pathogenesis, clinical manifestations, diagnostic challenges, management, and treatment. Special emphasis is placed on the emerging epidemic of steroid-modified dermatophytosis in India, driven by over-the-counter drug availability and irrational prescribing practices, leading to chronic, recurrent, and recalcitrant cases. Understanding these effects is essential for microbiologists and clinicians to enhance antifungal stewardship, treatment outcomes, and diagnostic precision.