Short-duration treatment of fingernail dermatophytosis: a randomized, double-blind study with terbinafine and griseofulvin. LAGOS III Study Group.
BACKGROUND
Dermatophytic infections of the fingernail can be effectively treated with oral antifungal agents; however, a long duration of treatment, generally several months, is required for cure.


OBJECTIVE
Our purpose was to compare the efficacies of short-duration treatment with terbinafine and griseofulvin in the management of fingernail dermatophytosis.


METHODS
In this randomized, double-blind study 180 patients with fingernail dermatophytosis were treated with daily doses of either terbinafine, 250 mg/day, or microsized griseofulvin, 500 mg/day, for 12 weeks. Patients subsequently received placebo for 12 weeks and were observed for an additional 24 weeks. Drug efficacy was assessed by mycologic examination and measurement of the growth of unaffected nail.


RESULTS
At the end of the study 76% of the group who received terbinafine and 39% of those who received griseofulvin were found to be completely cured (p = 0.001). Drug tolerability was equally good in both treatment groups, without any clinically relevant changes in laboratory biochemical values.


CONCLUSIONS
Short-duration treatment (3 months) for fingernail dermatophytosis with terbinafine and griseofulvin is well tolerated. However, terbinafine was associated with a higher cure rate.
Haneke
E
E
Department of Dermatology, Ferdinand-Sauerbruch-Hospital Wuppertal, Germany.
Tausch
I
I
Bräutigam
M
M
Weidinger
G
G
Welzel
D
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000187:drug effects; D000935:Antifungal Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D004311:Double-Blind Method; D003875:Drug Eruptions / Q000209:etiology; D005260:Female; D005385:Fingers; D005500:Follow-Up Studies; D005767:Gastrointestinal Diseases / Q000139:chemically induced; D005858:Germany; D006118:Griseofulvin / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009281:Naphthalenes / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D014009:Onychomycosis / Q000188:drug therapy* / Q000382:microbiology; D000077291:Terbinafine; D013997:Time Factors; D016896:Treatment Outcome
D000935:Antifungal Agents; D009281:Naphthalenes; D006118:Griseofulvin; D000410:Alanine Transaminase; D000077291:Terbinafine