Treatment Outcome and Relapse with Short-term Oral Terbinafine (250 mg/day) in Tinea Pedis

Department of Dermatology, Showa University Fujigaoka Hospital, Kanagawa, Japan.
Nippon Ishinkin Gakkai Zasshi 02/2005; 46(4):285-9. DOI: 10.3314/jjmm.46.285
Source: PubMed


A total of 168 patients with tinea pedis, but without onychomycosis, were treated with 1 cycle of terbinafine (TBF) (1 cycle: defined as 250 mg/day for 1 week). KOH preparation for direct microscopy was performed 4, 8 and 12 weeks after starting therapy to determine if testing was positive for tinea. Patients with no negative results on KOH examination or no evidence of obvious clinical improvement at 8 weeks, another cycle of the therapy was prescribed. The "cure", "no cure", "dropout", and "discontinuation/unevaluable" rates were 89.3%, 4.8%, 4.8% and 1.2%, respectively. The number of cycles required for cure in the plantar type was 1 cycle in 65.9% and 2 cycles in 54.5% of cases; in the interdigital type, 1 cycle in 79.1% and 2 cycles in 20.9% of cases; and mixed type, 1 cycle in 29.1% and 2 cycles in 60.9% cases. Among patients who were followed for at least 3 years after cure, the relapse rates were about 10% each year: 1 year, 11.3%; 2 years, 8.9%; and 3 years, 11.2%. The relapse rate of about 10% each year over a 3-year period suggests that reinfection may be likely.

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    • "Once an infection is established, the wearing of sports shoes and other types of occlusive footwear provides an ideal microclimate in which these fungi can thrive, and may lead to nail infections (tinea unguium), which are inherently harder to treat. It has been estimated that there is a relapse rate of 10 % a year in cases of tinea pedis treated with oral terbinafine (Takiuchi et al., 2005), while 22 % of patients with tinea unguium treated with systemic antifungals relapse within 3 years (Tosti et al., 1998). The design of effective intervention measures to break the cycle of transmission is a central requirement for reducing the incidence of dermatophytoses. "
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