Efficacy of ciclopiroxolamine 1% cream in onychomycosis and tinea pedis.

Ciclopiroxolamine is now under use as an antifungal agent for about a decade. Its activity is well-known in moderate climates, but there is a lack of knowledge on the activity in tropical and subtropical areas. 49 patients suffering from onychomycosis (42) and/or tinea pedis (33) were enrolled in a clinical trial in Taiwan. The patients received ciclopiroxolamine 1% cream 2-3 times a day for 3 to 24 month. In addition, infected nails were filed to facilitate drug penetration. In onychomycosis, 14% of the patients were cured and another 36% improved. One patient relapsed after 10 months. Cure was achieved more easily, if there were only modest alterations of the nail plate. With respect to tinea pedis the results were more favourable, the cure rate was 42%, another 45% of the patients improved. Following this dosage regimen, side effects did not occur. The results show onychomycosis to be highly resistant to antifungal therapy, perhaps even more as compared to tinea pedis in temperate climates. The good tolerability favours topical ciclopiroxolamine for this recalcitrant disease.