title: Preventing long term relapsing tinea unguium with topical anti-fungal cream: a case report.
abstract: BACKGROUND
  The patient was aged 34 when he consulted a dermatologist in Vancouver BC with onychomycosis affecting the right great toenail.
  
  
  METHODS
  Trichophyton rubrum was cultured from nail clippings. Griseofulvin was taken for 6 months, resulting in clinical and mycological cure. Over the next 27 years there were multiple relapses. Each course of treatment with oral terbinafine (for up to 18 months) or itraconazole resulted in clinical and mycological cure. A dermatological colleague suggested the reason for relapse was likely to be self re-infection.
  
  
  CONCLUSIONS
  No clinical relapse has occurred with once-weekly miconazole cream applied to the toenail and webspaces of the right foot over the last four years.
authors.affiliation: University of Auckland, Private Bag 92019, Auckland, New Zealand. b.arroll@auckland.ac.nz.
authors.forename: Bruce
authors.initials: B
authors.lastname: Arroll
authors.forename: Amanda
authors.initials: A
authors.lastname: Oakley