A doubleblind comparative study with 1% clotrimazole/ 1% hydrcortisone in clinically diagnosed fungal infection of the skin. One author (FC) obtained the full text of all studies of possible relevance for independent assessment. Comparison 4 Comparisons between different allylamines or allylamine regimes, Outcome 1 Short term (2 weeks) treatment failure. 1. Other topical agents such as azoles, ciclopiroxolamine, butenafine, tolnaftate and undecanoate were also effective in curing athlete's foot. Amorolfine 0.125, 0.25 and 0.5. New citation required and conclusions have changed, New studies found and included or excluded, 2.2 Clotrimazole (tx 46 weeks) vs Placebo, 2.3 Miconazole nitrate (tx 4 weeks) vs Placebo, 2.5 Sulconazole nitrate (tx 46 weeks) vs Placebo, 3.2 Miconazole nitrate (tx 4 weeks) vs Placebo, 3.4 Sulconazole nitrate (tx 46 weeks) vs Placebo, 2.3 Ciclopiroxolamine (tx 4 weeks) vs Placebo, 2.7 Undecanoates (tx 46 weeks) vs Placebo / no treatment, 3.1 Ciclopiroxolamine (tx 4 weeks) vs Placebo, 3.5 Undecanoates (tx 46 weeks) vs Placebo / no treatment, 1.1 Naftifine once daily vs Naftifine twice daily, 2.1 Naftifine once daily (tx 4 weeks) vs Naftifine twice daily (tx 4 weeks), 2.2 Naftifine (tx 2 weeks) vs Terbinafine (tx 2 weeks), 2.3 Terbinafine (tx 57 days) vs Terbinafine (tx 1 3 days), 2.4 Terbinafine (tx 4 weeks) vs Terbinafine (tx 1 week), 3.1 Naftifine once daily (tx 4 weeks) vs Naftifine twice daily (tx 4 weeks), 3.2 Naftifine (tx 2 weeks) vs Terbinafine (tx 2 weeks), 3.3 Terbinafine (tx 57 days) vs Terbinafine (tx 13 days), 4.1 Terbinafine (tx 57 days) vs Terbinafine (tx 1 3 days), 4.2 Terbinafine (tx 4 weeks) vs Terbinafine (tx 1 week), 1.3 Miconazole nitrate vs Sulconazole nitrate, 1.4 Oxiconazole twice daily vs Oxiconazole once daily, 2.1 Bifonazole (tx 3 weeks) vs Bifonazole removed after 1 hr (tx 3 weeks), 2.2 Bifonazole (tx 3 weeks) vs Croconazole (tx 3 weeks), 2.3 Bifonazole (tx 3 weeks) vs Miconazole (tx 3 weeks), 2.4 Clotrimazole (tx 4 weeks) vs Clotrimazole (tx 1 week), 2.5 Clotrimazole (tx 24 weeks) vs Econazole (tx 24 weeks), 2.6 Econazole gel (tx 2 weeks) vs Econazole cream (tx 2 weeks), 2.7 Clotrimazole (tx 4 weeks) vs Ketoconazole (tx 4 weeks), 2.8 Miconazole (tx 6 weeks) vs Ticonazole (tx 6 weeks), 2.9 Oxiconazole+fluctic (tx 4 weeks) vs Oxiconazole (tx 4 weeks), 2.10 Oxiconazole twice daily (tx 4 weeks) vs Oxiconazole once daily (tx 4 weeks), 2.11 Bifonazole (tx 4 weeks) vs flutrimazole (tx 4 weeks), 3.1 Bifonazole (tx 3 weeks) vs Bifonazole removed after 1 hr (tx 3 weeks), 3.2 Bifonazole (tx 3 weeks) vs Croconazole (tx 3 weeks), 3.3 Bifonazole (tx 3 weeks) vs Miconazole (tx 3 weeks), 3.4 Clotrimazole (tx 24 weeks) vs Econazole (tx 24 weeks), 3.5 Econazole gel (tx 2 weeks) vs Econazole cream (tx 2 weeks), 3.6 Miconazole (tx 6 weeks) vs Ticonazole (tx 6 weeks), 3.7 Oxiconazole+fluctic (tx 4 weeks) vs Oxiconazole (tx 4 weeks), 3.8 Oxiconazole twice daily (tx 4 weeks) vs Oxiconazole once daily (tx 4 weeks), 4.1 Clotrimazole (tx 4 weeks) vs Clotrimazole (tx 1 week), 3.1 Naftinfine/Terbinane 2 weeks vs Oxiconazole 2 weeks, 2.1 Terbinafine 1% (tx 1 week) vs Ajoene 0.6% (tx 1 week), 2.2 Terbinafine 1% (tx 1 week) vs Ajoene 1% (tx 1 week), 2.1 Bifonazole (tx 6 weeks) vs Amorolfine (tx 6 weeks), 2.2 Clotrimazole (tx 4 weeks) vs Ciclopirox olamine (tx 4 weeks), 3.1 Bifonazole (tx 6 weeks) vs Amorolfine (tx 6 weeks), 3.2 Clotrimazole (tx 4 weeks) vs Ciclopirox olamine (tx 4 weeks), 1.1 Salicylic acid + nitrite vs Salicylic acid, 2.1 Ajoene 1.0% (tx 1 week) vs Ajoene 0.6% (tx 1 week), 2.2 Amorolfine 0.25 (tx 4 weeks) vs Amorolfine 0.125 (tx 4 weeks), 2.3 Amorolfine 0.5 (tx 4 weeks) vs Amorolfine 0.125 (tx 4 weeks), 2.4 Amorolfine 0.5 (tx 4 weeks) vs Amorolfine 0.25 (tx 4 weeks), 2.5 Haloprogen (tx 4 weeks) vs Tolnaftate (tx 4 weeks), 2.6 Salicylic acid + nitrite (tx 4 weeks) vs Salicylic acid (tx 4 weeks), 2.7 Tea tree oil 50% (tx 4 weeks) vs Tea tree oil 25% (tx 4 weeks), 2.8 Tea tree oil (tx 4 weeks) vs Tolnaftate (tx 4 weeks), 2.9 Tolnaftate (tx 4 weeks) vs Undecylenate acid (tx 4 weeks), 3.1 Whitfields (tx 8 weeks) vs Varotin(tx 8 weeks), 4.1 Amorolfine 0.25 (tx 4 weeks) vs Amorolfine 0.125 (tx 4 weeks), 4.2 Amorolfine 0.5 (tx 4 weeks) vs Amorolfine 0.125 (tx 4 weeks), 4.3 Amorolfine 0.5 (tx 4 weeks) vs Amorolfine (tx 0.25 4 weeks), 4.4 Haloprogen (tx 4 weeks) vs Tolnaftate (tx 4 weeks), 4.5 Salicylic acid + nitrite (tx 4 weeks) vs Salicylic acid (tx 4 weeks), 4.6 Tea tree oil (tx 4 weeks) vs Tolnaftate (tx 4 weeks), 4.7 Tolnaftate (tx 4 weeks) vs Undecylenate acid (tx 4 weeks), 1.1 Ciclopiroxolamine versus placebo. RodriguezNoriega A. Czernielewski J. No trials reported quality of life as measured by the cosmetic acceptability of the end result to the participant, absence of itchiness, independence from medical treatment and advice with respect to the condition. (iv) whether the baseline comparability of groups was reported (based on age, sex, and duration of complaint); Desai A. Efficacy and safety of butenafine in superficial dermatophytosis, Journal of the Indian Medical Association, 2% miconazole nitrate powder in aerosol spray form: its efficacy in treating tinea pedis, Topical clotrimazole in dermatophytosis in a prison environment. We looked at the included RCTs for reports of adverse effects of the interventions. EconLit Different types of allylamines or different doses were not found to have different treatment failure rates. Cuetara S, Fungal infections of the skin and nails of the foot are common, reflecting the contagious nature of the organisms. Since no trial reported the species obtained from participants who were resistant to treatment we cannot draw conclusions about susceptibility to individual compounds to help clinical decisionmaking. et al. Cochrane Database of Systematic Reviews 2016, Issue 2. Sulconazole nitrate 1% cream in the treatment of chronic moccasin type tinea pedis caused by trichophyton rubrum, Journal the of American Academy of Dermatology. Upgrade to Patient Pro Medical Professional? In: Urabe H, editor, Doubleblind parallel comparison of sulconazole nitrate 1% cream and powder with econazole 1% cream and powder in the treatment of cutaneous dermophytoses, Topical treatment of onychomycosis with Almorolfine 5% nail laquer: comparative efficacy and tolerability of once weekly use. Vollum D, Combining data from 3 of the trials which had at least 80% followup (n = 685, Evans 1993b; Leenutaphong 1999; Schopf 1999) also did not show a statistically different difference in the treatment failure rates (RR 0.50, 95% CI 0.10 to 2.54; Analysis 7.2). We searched EMBASE (from inception to January 2005) using the following keywords: athlete's foot, tinea pedis, topical treatment and onychomycosis. If you are using salicylic acid for a nail infection, do not use nail varnish or artificial nails at the same time. We found lots of evidence to show fungal skin infections of the skin of the feet (athlete's foot or tinea pedis) are effectively managed by over the counter topical antifungal creams, lotions and gels. Twelve studies evaluating topical treatments for skin infections which were included in the previous version of this review were excluded in this update (Daily 1985; Duncan 1975; Thomas 1976; Ortiz 1978; Tschen 1979; Smith 1977b; Fredriksson 1982; Privat 1982; Thomas 1986; Greer 1986; Tanenbaum 1982; Tsuboi 1996). Bergstrasser PR, Tangwiwat S, Comparative study of monotherapy and combination therapy with 10% urea ointment (Pastaron), Efficacy and tolerability of of kevis nails associated with antimycotic product in the treatment of onychomycosis, A study in industry of clotrimazole cream in tinea pedis and tinea cruris, A study in Industry of Bifonazole (1%gel) and sulconazole cream in tinea pedis and tinea cruris. Adverse events;non serious. (iii) whether the inclusion and exclusion criteria were defined We searched the Cochrane Skin Group Specialised Register (January 2005), the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 1, 2005), MEDLINE and EMBASE (from inception to January 2005). Marcano K, The written report of the study is too confusing to be able to extract the appropriate data, Combined data for hands and feet infections, No mycological assessment was carried out, Compares systemic treatment with topical treatment, Study looks at bacterial infection as well as fungal infection and does not separate the results, Cannot separate mycological results for tinea pedis of the skin from infection of the nail, One hundred and four (104/217) only had culture confirmed at baseline. et al. SH undertook all the statistical analyses associated with this version of the review. Comparison 6 Allylamines 12 weeks vs Azoles 12 weeks, Outcome 4 Long term (12 weeks onwards) treatment failure. Kaben U, Only >=80% followup included. Hanifin JM, Leyden J, Econazole gel versus econazole cream Qureshi ZA, Gammon WR, Elewski B, FC and SH jointly wrote the text of the review and are both guarantors of the work. Dated March 2015. Nolting S, This review only included trials which reported the use of microscopy and culture tests to confirm the presence of fungi. (viii) was the distribution of species between groups stated; (vi) whether the compliance was assessed;

(ringworm or (athlete* next foot) or (tinea next pedis)) A very small trial comparing Whitfield's ointment versus variotin applied for 8 weeks (n = 10, Holti 1970) did not detect a statistically significant difference between the 2 treatments (RR of treatment failure 1.33, 95% CI 0.17 to 10.25; Analysis 11.3). The nails often appear changed in colour; they may be thickened and changed in texture (Beaven & Brooks 1994). Savin R, Try not to get salicylic acid on healthy areas of skin and do not apply it to skin which is raw or inflamed. No microscopy for any participant, Data combined for three sites; tinea pedis, tinea cruris, tinea corporis, Culture is used to identify pathogens at baseline but not to assess outcome, Results for mycological cure do not separate out those for tinea pedis from tinea cruris, Cannot separate tinea pedis results from those of tinea corporis and inguilalis. Two authors checked titles and abstracts identified from the searches. Vaananen A, Clinical efficacy of compound econazole cream in the treatment of tinea corporis, tinea inguinalis, and tinea manus, tinea pedis and its safety, Parmaceutical care and research (Yaoxue fuwu yu yanjiu), Treatment of tinea pedis with micronized griseofulvin and tolnaftate, Iodochlorhydroxyquinhydrocortisone treatment of fungal infections. 3. PMC legacy view RESEARCH DESIGN.sh. Tanji J. Efficacy of tolciclate solution in patients with tinea pedis, Ciclopirox nail lacquer topical solution in the treatment of toenail onychomycosis, Naftifin in foot mycoses. ( MICONAZOLE or DAKTARIN ) ti,ab,sh. If you have ever had an allergic reaction to a medicine.

No. 39. sharing sensitive information, make sure youre on a federal 17.

Drake LA, Ledezma 2000 compared terbinafine 1% for 1 week with ajoene 0.6% and 1.0% (n = 47). All antifungal compounds demonstrated some success in curing athlete's foot. One trial comparing 1% terbinafine versus 1% butenafine (Syed 2000 n = 40) found no statistically significant difference in treatment failure at 2 weeks (RR 2.00, 95% CI 0.41 to 9.71; Analysis 9.1). A trial comparing outcomes from 1% terbinafine used for 4 weeks versus 1% terbinafine used for 1 week (n = 80, Bergstresser 1993) found less slightly treatment failures with 4 weeks treatment, but the difference was not statistically significant (RR of treatment failure at 12 weeks 0.60, 95% CI 0.24 to 1.54; Analysis 4.4). Hata Y, 15.

Randomised controlled trials (RCTs) using participants who had mycologically diagnosed fungal infections of the skin and nails of the foot.

Overall the pooled estimated relative risk of treatment failure (n = 329, 5 trials) of 1% azoles (bifonazole or oxiconazole) versus placebo at 2 weeks was 41% (RR 0.59, 95% CI 0.43 to 0.82; Analysis 2.1), though there was considerable variation between the results for the 2 different azoles (overall I2 = 50%). ( DERMATOPHYT$ or DERMATOMYCOSES ) ti,ab,sh. Weller 1998 evaluated salicylic acid plus nitrite versus salicylic acid both used for 4 weeks (n = 35) and found that the addition of nitrite provided a statistically significant relative reduction in treatment failure of 54% (RR 0.46, 95% CI 0.22 to 0.96; Analysis 11.4), followup was at least 80%. Ulrich JA, Comparison 11 Comparisons between other topical antifungal treatments, Outcome 1 Short term (2 weeks) treatment failure. Shortterm outcome was reported only in the four trials of bifonazole, and one trial of oxiconazole. Metaanalysis of 11 trials comparing allylamines and azoles showed a risk ratio of treatment failure RR 0.63 (95% CI 0.42 to 0.94) in favour of allylamines. The text in 'Effects of interventions' part (b) Nails trials was also amended to include this change. et al. (vii) were the infecting fungi identified; Tolnaftate (1%) used for 4 weeks was compared with placebo in 2 trials (n = 115, Fuerst 1980; Tong 1992) and a statistically significant relative reduction in treatment failure of 70% was found (RR 0.30, 95% CI 0.13 to 0.72; Analysis 3.2), with at least 80% followup in both trials. Belli L, Bell C, The way you put it provides evidence that tea tree oil is ineffective. Ahmad SA. In order to reduce bias from trials with high loss to follow up whilst recognising the practical constraints in which RCTs of athlete's foot generally take place, we performed a sensitivity analysis only including data which reported follow up data for at least 80% of the randomised sample.

Evidence about the efficacy of topical treatments for nail infections is sparse. Aly R, Evans EGV, Ajoene 0.6% and 1.0% ( TOE or TOES ) ti,ab,sh. (#22 or #23 or #24) Plotkin E, Before Comparative efficacy and safety of amorolfine nail laquer 5% in onychomycosis. PARONYCHIA Longterm (12 weeks onwards): longest followup of at least 12 weeks. Feedback in response to comments made by Micheal Power. Treatment of interdigital tinea pedis with a 4 week oncedaily regimen of butenafine hydrochloride 1% cream. In common with the trials of allylamines versus placebo, azole creams are very much more effective than placebo, with an estimated relative reduction in treatment failure at 6 weeks of 60% (13 trials, n = 1235, RR 0.40, 95% CI 0.35 to 0.46; Analysis 2.2). Only >=80% followup included.. A L'Abb plot of the outcomes at six weeks (Figure 5) demonstrates that the allylamines had broadly similar treatment failure rates to the azoles, with a wide variation in failure rates. i have been born with bended toes and i never payed attention to it but my toes are crooked , they give me corns and it hurts. 55. Cintio R, Broeckx W, Kiely JJ, All randomised controlled studies of topical treatment for fungal infections of the skin and nails of the foot. This was useful to illustrate the range of treatment failure rates among the trials, and the amount of heterogeneity between trials and sub groups. These outcomes followed long treatment times (48 weeks) and this makes ciclopiroxolamine a poor choice for nail infections. Liu WD, Patel A, Manufacturer's PIL, Occlusal 26%w/w cutaneous solution; Alliance Pharmaceuticals, The electronic Medicines Compendium. I have referred to the original paper (Syed 1999) and can confirm that the criticism is valid; the comparisons were 2% Butenafine together with 5% melaleuca alternifolia versus placebo and I agree that the text should read "A comparison of 2% butenafine and 5% tea tree oil produced a relative risk 0.03; 95% CI 0.00 to 0.47 at 36 weeks showing butenafine and tea tree oil to be statistically significantly more effective than placebo alone.