title: [Topical treatment of onychomycosis by occlusive dressing using bifonazole cream containing 40% urea].
abstract: Topical treatment with an antifungal agent was performed in 70 cases of onychomycosis (69 cases of tinea unguium and 1 case of Candida onychomycosis). The patients were treated every night by occlusive dressing using bifonazole cream containing 40% urea, and then by simple application of 1% bifonazole solution in the morning. During the treatment period, the softened affected nails were removed as completely as possible with nail clippers and files. The nails were observed every two weeks, and the efficacy was evaluated after 12 weeks. Two cases were excluded and 28 cases dropped out leaving 40 cases for efficacy evaluation. Among the 40 patients, 20 appeared to be mycologically negative (mycological cure rate: 50.0%). Clinical response was judged by the changes in opacity and thickness of the nails. Nine patients were evaluated as showing "marked improvement" and 16 as showing "improvement" (improvement rate: 62.5%). Erosion was noted as an adverse reaction in 2 patients. In one patient, treatment was stopped and the lesion was improved by antibiotic ointment, and in another, treatment was resumed when erosion was cured by discontinuation of the treatment. These results suggest that the topical treatment of onychomycosis by occlusive dressing is a useful method for those patients who have difficulties in or do not wish to be treated with oral antifungal agents.
authors.affiliation: Department of Dermatology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Tsuboi
authors.forename: K
authors.initials: K
authors.lastname: Unno
authors.forename: H
authors.initials: H
authors.lastname: Komatsuzaki
authors.forename: H
authors.initials: H
authors.lastname: Ogawa
authors.forename: T
authors.initials: T
authors.lastname: Kasai
authors.forename: K
authors.initials: K
authors.lastname: Oka
authors.forename: I
authors.initials: I
authors.lastname: Takiuchi
authors.forename: K
authors.initials: K
authors.lastname: Kitamura
authors.forename: N
authors.initials: N
authors.lastname: Higashi
authors.forename: Y
authors.initials: Y
authors.lastname: Nakashima
authors.forename: K
authors.initials: K
authors.lastname: Nishimoto
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000008:administration & dosage*; D002177:Candidiasis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009779:Occlusive Dressings; D014009:Onychomycosis / Q000188:drug therapy* / Q000382:microbiology; D014508:Urea / Q000008:administration & dosage
chemical_list: D000935:Antifungal Agents; D007093:Imidazoles; D014508:Urea; C036596:bifonazole