A multicenter, open-label study of the efficacy and safety of ciclopirox nail lacquer solution 8% for the treatment of onychomycosis in patients with diabetes.

This multicenter, open-label, uncontrolled, noncomparative, observational, postmarketing study assessed the efficacy and safety of ciclopirox nail lacquer solution 8% in 3666 patients for the treatment of onychomycosis. Results of an analysis in a subset of 215 (5.9%) patients with diabetes are summarized here. Patients applied ciclopirox nail lacquer once daily to affected toenails and fingernails for 6 months. Efficacy parameters included the decrease from baseline of the affected area of the nail. Physicians rated the level of onychomycosis at 3 months and the efficacy of ciclopirox nail lacquer at 6 months. Treatment with ciclopirox nail lacquer reduced the mean affected nail area from 64.3% at baseline to 41.2% at 3 months and 25.7% at 6 months. At 3 months, physicians rated onychomycosis as improved in 88.7% of patients. unchanged in 9.8%, and worse in 1.5%. The efficacy of ciclopirox nail lacquer was good in 62.0% of patients, satisfactory in 23.9%, and unsatisfactory in 14.1%. Adverse events were mild to moderate, with no serious events reported. Ciclopirox nail lacquer is safe and effective for the topical treatment of onychomycosis in patients with diabetes and produced results similar to those observed in the general population.

Tinea capitis in Germany. A survey in 1998.

Under the assignment of the ECMM (European Confederation of Medical Mycology) a survey regarding frequency, infectious spectrum and therapy of tinea capitis was conducted in Germany in 1998. In this survey 154 dermatology practitioners and 19 hospitals throughout Germany participated. There were 394 conditions reported, 377 with and 17 without identification of the infectious agent. The most frequent infectious agent was M. canis (n = 216; 54.8%) before T. mentagrophytes (n = 58; 14.7%), T. verrucosum (n = 32; 8.1%), T. violaceum (n = 24; 6.1%) and T. tonsurans (n = 15; 3.8%). Zoophilic dermatophytes (n = 306; 81.2%) predominated over anthropophilic species (n = 71; 18.8%) in the ratio of 4:1. Tinea capitis microsporica showed to be a more frequent infectious disease again which due to its high virulence and contagiosity of the infectious agent represents a therapeutical problem. Tinea capitis occurred in an average age of 17.3 years. The preferred therapeutical regimen was a combination of systemic and topical antimycotics in 61.5% (n = 176) of the reported cases (n = 286). A solely topical or systemical monotherapy was reported in 25.2% (n = 72) respectively 13.3% (n = 38) of the patients. In case of systemic antimycotics the most frequent used drugs were griseofulvin (43.0%, n = 101), fluconazole (25.1%, n = 59) or itraconazole (18.7%; n = 44), in topical preparations ciclopiroxolamine dominated (53.3%, n = 121) prior to clotrimazole (13.2%, n = 30) and terbinafine (7.1%, n = 16). Different from the situation in Germany and in Southern Europe some of the western European countries show a tendency of an increase of anthropophilic agents in tinea capitis.

Tinea capitis in Germany. A survey in 1998.

Under the assignment of the ECMM (European Confederation of Medical Mycology) a survey regarding frequency, infectious spectrum and therapy of tinea capitis was conducted in Germany in 1998. In this survey 154 dermatology practitioners and 19 hospitals throughout Germany participated. There were 394 conditions reported, 377 with and 17 without identification of the infectious agent. The most frequent infectious agent was M. canis (n= 216; 54,8%) before T. mentagrophytes (n = 58; 14,7 %), T. verrucosum (n = 32; 8,1 %), T. violaceum (n = 24; 6, 1 %) and T. tonsurans (n = 15; 3,8%). Zoophilic dermatophytes (n = 306; 81,2%) predominated over anthropophilic species (n = 71; 18,8%) in the ratio of 4:1. Tinea capitis microsporica showed to be a more frequent infectious disease again which due to its high virulence and contagiosity of the infectious agent represents a therapeutical problem. Tinea capitis occured in an average age of 17,3 years. The preferred therapeutical regimen was a combination of systemic and topical antimycotics in 61,5% (n = 176) of the reported cases (n = 286). A solely topical or systemical monotherapy was reported in 25,2 % (n = 72) respectively 13,3 % (n = 38) of the patients. In case of systemic antimycotics the most frequent used drugs were griseofulvin (43,0%, n = 101), fluconazole (25,1%, n = 59) or itraconazole (18,7%; n = 44), in topical preparations ciclopiroxolamine dominated (53,3 %, n = 121) prior to clotrimazole (13,2%, n = 30) and terbinafine (7,1 %, n = 16). Different from the situation in Germany and in Southern Europe some of the western European countries show a tendency of an increase of anthropophilic agents in tinea capitis.