Back issues No.3 - 1997 / Original Study  

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An Open Study to Compare the Efficacy and Tolerability of Terbinafine with Griseofulvin in Onychomycosis
Heng-Leong Chan, Li-Cheng Yang
Dermatol Sinica 15: 157-161, 1997

Griseofulvin has been regarded as a standard treatment of dermatophyte onychomycosis.1 The treatment of onychomycosis with griseofulvin are unsatisfactory due to low cure rate; in most infections, therapy must be prolonged with accompanying problems of patient compliance and treatment failure.2 Onychomycosis caused by candida and mold are not respond to griseofulvin treatment. Ketoconazole is effective in the treatment of candida onychomycosis but this agent may cause hepatic damage in idiosyncratic patients.3,4 Recently, the clinical efficacy of oral terbinafine has been demonstrated in onychomycosis, tinea corporis and cutaneous candidiais.5 Previous investigators showed that cures of onychomycosis required shorter course of treatment than with existing drugs.6Totally 40 patients completed this study, 20 in each group. The treatment course of terbinafine was 6 weeks (finger nails) or 4 months (toe nails), wherease, of griseofulvin, around 6 and 8 months. Every patient received KOH examination, fungal culture and/or histopathological examination before and after treatment. Monitering of CBC, liver enzymes and urinalysis were performed before and every two weeks after initiation. Result:85% of the terbinafine treated group obtained clinical and mycologic cure, whereas the griseofulvin treated group was 60%(p<0.05) Tolerability: In terbinafine treated group, diarrhea occurred in 2 patients and liver enzyme elevation in one, whereas in griseofulvin treated group, headache occurred in one, skin rash in one and liver enzyme elevation in two patients. Conclusion: The treatment of onychomycosis with terbinafine was well tolerated and achieved a short course-high cure rate, even in some candidal onychomycosis.

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