Croconazole hydrochloride is a new antifungal agent of the imidazole type. A 1% croconazole cream (Pilzcin, Merz + Co., D-Frankfurt/Main) was investigated in a multicentre trial involving 132 patients (mean age 46.7 +/- 15.5 years; 69 men, 63 women) suffering from tinea pedis (interdigital space, n = 86; other foot sites, n = 46). The fungal infections were caused predominantly by Trichophyton rubrum (interdigital space, n = 43; other foot sites, n = 33), followed by other Trichophyton and Candida species. The patients were treated once daily for a period of up to 3 weeks. In the majority of cases complete cure was achieved at both locations. On fungal microscopy no fungi were seen after 3 weeks in 82.6% of patients in the 'interdigital space' group and in 80.4% of patients in the 'other foot sites' group. Two weeks after the end of the treatment no fungi could be found in culture in 81.4% of the patients in the 'interdigital space' group and in 80.4% of patients in the other group. All skin symptoms of the mycoses (itching, scaling, erosions, reddening) decreased during the observation period. In 82.6% of patients in the 'interdigital space' group and in 76.1% of patients treated in the 'other foot sites' group efficacy was rated by the physician as good or very good. Tolerability was evaluated as good or very good in 90.7% and 89.1% of the cases. Local skin intolerabilities were not observed. The therapeutic results show that croconazole cream, when applied once a day, is an effective and well-tolerated drug for the treatment of tinea pedis, regardless of its location.
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