Combination treatment of oral terbinafine with topical terbinafine and 10% urea ointment in hyperkeratotic type tinea pedis

Abstract

Hyperkeratotic-type tinea pedis is chronic and recalcitrant to topical antifungal agents. Some topical antifungal agents are effective; however, long duration of therapy is required, which often reduce the treatment compliance of patients. To seek for short period therapy of hyperkeratotic type tinea pedis, in this study, we observed the efficacy and safety of treatment of topical terbinafine and 10% urea ointment combined oral terbinafine. Participants with hyperkeratotic type tinea pedis were randomly assigned to two groups. Patients in group I were treated with oral terbinafine for 2 weeks and topical terbinafine and 10% urea ointment for 4 weeks, whereas in group II, only the above topical agents were applied for 12 weeks. Clinical improvement rates and fungal eradication rates were compared between the two groups at 24 weeks after the initiation of treatment. The group I had stopped the topical therapy 8 weeks earlier than group II. There were no significant differences in mycological eradication rates and clinical improvement rates between the two groups, besides, no major side effects were noted in both groups. The short combination therapy with oral terbinafine was effective and safe; it should be a valuable option for patients with hyperkeratotic type tinea pedis.

Indian association of dermatologists, venereologists and leprologists (IADVL) task force against recalcitrant tinea (ITART) consensus on the management of glabrous tinea (INTACT)

“…Keratolytics have been used for the treatment of dermatophytosis, especially hyperkeratotic tinea pedis. [ 83 84 ] Topical keratolytics, such as Whitfield's ointment (3% salicylic acid with 6% benzoic acid), can be used in the treatment of glabrous tinea, but not on the flexures or face or where the lesions are inflamed. [ 85 86 ]…”

Management of tinea corporis, tinea cruris, and tinea pedis: A comprehensive review

“…Use of keratolytic agents and topical antifungals along with systemic antifungals has been found to be more useful in early achievement of clinical and mycological cure as well as decreasing the duration of oral antifungals leading to better patient compliance. [ 51 ] Secondary bacterial infection should be treated with oral antibiotics. Other adjunctive therapies include use of antifungal powder may help to prevent maceration and avoidance of occlusive footwear.…”

A comparative study on efficacy of oral terbinafine and itraconazole on dermatophytic infections

“…10 The efficacy of itraconazole as well as terbinafine in management of dermatophyte infections has been reported in a number of studies. 11,[12][13][14][15][16] From a clinician point of view, it would be important to judge which of the two drugs is better under standard clinical scenario.…”