Clinical comparison and complete cure rates of Terbinafine efficacy in affected onychomycotic toenails.

BACKGROUND: Clinical studies regarding complete cure rate of onychomycosis using oral Terbinafine have a very broad range (14-90%) based solely on response to treatment on the big toenail. OBJECTIVE: To evaluate the efficacy of Terbinafine in all affected onychomycotic toenails and, furthermore, to evaluate differences in mycological, clinical and complete cure rate between affected onychomycotic toenails. PATIENTS AND METHODS: Inclusion criteria are as follows: distolateralsubungual onychomycotic involvement of the hallux and additional involvement of at least two more toenails of the same foot. Exclusion criteria are as follows: patients with nail traumata and hypersensitivity to Terbinafine. Patients were treated with oral Terbinafine 250 mg/day for 16 weeks. Mycological analysis was performed using direct microscopy and culture. Clinical improvement was assessed using digital photography. RESULTS: Statistically significant difference was found in clinical improvement between the great toenail and all other involved toenails. The rate of complete cure (100% clinical cure and mycological cure) of the big toenail was lower (23%) as compared to the second (65%), third (51%) and the fourth toenail (67%). LIMITATIONS: This is a case series study that was based on a single-centre cohort. CONCLUSIONS: Our results support findings that efficacy of Terbinafine should be based on all involved onychomycotic toenails; the big toenail is not superior in response compared to other affected toenails.

HL-A antigens in Behçet's disease. A family study.

Histocompatibility antigens (HL-A) were studied in a family with Behçet's disease (BD). All who had symptoms or signs of BD had either HL-A B5 or BW35, or both. The increased number of families with BD recently reported supports the suggestion that positive family history may assist the diagnosis of BD.