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- Author or Editor: Ivan R. Bristow x
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Topical and Oral Combination Therapy for Toenail Onychomycosis
An Updated Review
Although effective, oral antifungal therapy is still not completely successful. Recent studies have shown that combination therapy with oral and topical agents offers an increased cure rate for patients. We review the main drug combinations that have been tested. Additional measures, such as mechanical intervention, may help improve response rates further. (J Am Podiatr Med Assoc 96(2): 116–119, 2006)
Pitted Keratolysis
A Clinical Review
Background
Pitted keratolysis is a bacterial infection that affects the plantar epidermis. Despite the condition being reported in many countries affecting both shod and unshod populations, there is little guidance for clinicians providing evidence or best practice guidelines on the management of this often stubborn infection.
Methods
Using a structured search of a range of databases, papers were identified that reported treatments tested on patients with the condition.
Results
Most of the literature uncovered was generally of a low level, such as case-based reporting or small case series. Studies were focused mainly on the use of topical antibiotic agents, such as clindamycin, erythromycin, fusidic acid, and mupirocin, often in combination with other measures, such as hygiene advice and the use of antiperspirants. From the limited evidence available, the use of topical antibiotic agents shows some efficacy in the treatment of pitted keratolysis. However, there is currently no suggestion that oral antibiotic drug therapy alone is effective in managing the condition.
Conclusions
Currently, there is no consensus on the most effective approach to managing pitted keratolysis, but a combination of antimicrobial agents and adjunctive measures, such as antiperspirants, seems to demonstrate the most effective approach from the current literature available.
