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IndianJDermatol.2011NovDec56(6):657662.

PMCID:PMC3276891

doi:10.4103/00195154.91823

COMPARATIVEEVALUATIONOFEFFECTIVITYANDSAFETYOFTOPICAL
AMOROLFINEANDCLOTRIMAZOLEINTHETREATMENTOFTINEACORPORIS
ManasiBanerjee,AsimKumarGhosh,SukumarBasak,1KapilDevDas,2andDwijendraNathGangopadhyay2
FromtheDepartmentofPharmacology,MedicalCollege,Kolkata,India.
1
DepartmentofMycology,SchoolofTropicalMedicine,Kolkata,India.
2
DepartmentofDermatology,VenereologyandLeprosy,SchoolofTropicalMedicine,Kolkata,India.
Addressforcorrespondence:Dr.ManasiBanerjee,DepartmentofPharmacology,MedicalCollege,Kolkata,India.Email:
manasi.bnrj123@gmail.com
Received2011JulAccepted2011Oct.
Copyright:IndianJournalofDermatology
ThisisanopenaccessarticledistributedunderthetermsoftheCreativeCommonsAttributionNoncommercialShareAlike3.0Unported,
whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperlycited.

Abstract
Background:

Tineacorporisisacommonsuperficialdermatophytosisseenintropicalcountries.Newermoleculesare
constantlybeingintroducedforitstreatment.Topicalclotrimazoleisinvogueasthetreatmentforthis
conditionforalongtime.Amorolfineisacomparativelyrecentlyintroduceddrugfortopicaluseinthis
condition.
Aims:

Toassesstheeffectivityandsafetyofamorolfine0.25%creaminpatientswithtineacorporis,in
comparisontoclotrimazole1%cream.
MaterialsandMethods:

Patientspresentingwithsymptomsoftineacorporisweremycologicallyconfirmedforthepresenceof
fungalhyphae.Theywererandomlydividedintotwogroups:onegroupreceivedamorolfineandtheother
receivedclotrimazole.Treatmentdurationwasfor4weeksandstudydurationwasfor8weeks.Evaluation
wascarriedoutusingthestandardclinicalparametersonday1,day14,day28andafollowuponday56.
Adverseeffectswerealsorecorded.DataentrywasdoneinExceldatasheetandanalyzedwithEpiinfo
2002.Chisquaretestandttestwereusedaccordingtothetypeofdata.
Results:

Thepatientsofthetwogroupswerematchedatbaselineinrespecttotheirdemographicprofile.Analysis
ofcollecteddatashowedsignificantimprovementinboththegroups,suggestingthatboththedrugswere
effectiveagentsintineacorporisinfection.Betweengroupscomparisonofmycologicalcurerateand
clinicalimprovementshowednosignificantdifference.
Conclusion:

Amorolfine0.25%creamisfoundtobesafeandeffective,likeclotrimazole,whenusedtopicallyintinea
corporis.
Keywords:Amorolfine,clotrimazole,tineacorporis,topicalantifungalagents
Introduction
Superficialdermatophytosisoftheskinintheformoftineacorporisisaverycommoninfectionseenin
clinicalpractice.FungalinfectionsarecommoninhotandhumidclimateoftropicalcountrieslikeIndia.
Dermatophytesarefungithatinfectepidermisoftheskin,hairandnailduetocolonizationinthe
keratinizedlayers.[1]ThemostcommondermatophytesthatcausetineacorporisareTrichophyton
rubrum,Trichophytonmentagrophytes,MicrosporumcanisandTrichophytontonsurans.Typical
infectionshaveanannularappearancethatiscommonlyreferredtoasringworm.
AsurveyconductedbytheWorldHealthOrganizationontheprevalenceofdermatophyticinfectionhas
shownthat20%ofpeoplepresentingforclinicaladvicearesufferingfromcutaneousfungalinfections
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worldwide.[2]
Bothtopicalandsystemictherapiesmaybeusedtotreatdermatophyteinfections.Topicaltherapyis
generallyeffectiveforuncomplicatedtineacorporisofsmallareasandofshortduration.[3]Anytopical
agentusedforsuperficialfungalinfectionshastohavebroadspectrumactivity,highmycologicalcure
rate,convenientdosing,lowincidenceofsideeffectsandlowcost.Theimidazoleantifungalagent,
clotrimazole,hasbeenwidelyusedtopicallyforthetreatmentofsuperficialdermatophytosisforover25
years[4,5]withsatisfactionbypatientsandphysicians.Thereisasyetnoreportofresistancetothisdrug.
Therehasalwaysbeenasearchforbetterantifungals,bothsystemicandtopical.Someoftherecently
introducedmoleculesareusedexclusivelyfortopicalpurposes,somearesystemicandafewothersare
usedbothassystemicandtopicalagents.Recently,someoftheantifungalagentsthathavebeeninuseasa
systemicagentorinalacquerformfortineaunguiumhavebeenintroducedinthemarketinatopicalform
foruseintineacorporis.
Amorolfine,amorpholinederivative,isthefirstofanewclassofantifungaldrugs.Themechanismof
actionisinhibitionofergosterolbiosynthesisinthefungalcellmembrane.Alterationinthemembrane
sterolcontentleadstochangesinmembranepermeabilityanddisruptionofkeyfungalmetabolic
processes.[6,7]Therearestudiesregardingtopicaluseofamorolfineintheformofnaillacquerin
onychomycosis.[8,9]Amorolfineincreamformulationhasbeenstudiedforitssafetyandefficacyin
dermatomycoses,[10]althoughdataarerare,particularlyfromourcountry.Thus,amorolfinehasbeenseen
topossessantifungalproperties,butdataregardingeffectivityofthisdrugintineacorporisarelimited.A
topicalformulationofamorolfineas0.25%creamhasbeenrecentlyintroducedintheIndianmarketfor
useintineacorporis.Thisstudyaimstoassesstheeffectivityandsafetyofamorolfine0.25%creamas
comparedtoclotrimazole1%creamasatopicalantifungalagentindermatophyticinfection.
MaterialsandMethods
ScreeningofpatientsandrecruitmentwerecarriedoutatthedermatologyoutdoorclinicofSchoolof
TropicalMedicine,Kolkata,whichisatertiarycarehospital.Altogether,150adultpatientsofeithersexin
theagegroup1865yearswithaclinicaldiagnosisofmildtomoderategradesofdermatophytosis,who
satisfiedtheinclusionandexclusioncriteriaandconsentedtoparticipate,wereselectedforthestudy.
Necessaryethicalclearancewasobtainedfromtheinstitutionalethicalcommittee.
Thosewhohaduncontrolleddiabetes,wereHIVinfectedorsufferingfromconcomitantbacterialinfection
wereexcludedfromthestudy.Pregnantorlactatingmothersandfemalepatientsofthereproductiveage
grouppracticingunreliablemethodsofcontraceptionwereexcludedfromthestudy.Thosewhoreceived
systemicand/ortopicalantifungalagentsduringthelast1monthwerealsoexcluded.Thosewhohad
negativeskinscrapingforfungusfromaclinicallysuspectedlesiononbaselinevisitwerealsoexcluded
fromthestudy.
Thepatientsweredividedintothreegroupsrandomly.Eachgroupwasallocatedonetopicalantifungal,
namely,clotrimazole,amorolfineandanothersystemicantifungalmoleculenewlyintroducedfortopical
use,whichistobepublishedlater.
Studydesign Thiswasarandomized,controlledtrialwiththreeparalleltreatmentarms.Theselected150

patientswererandomlyofferedthreeantifungalcreamsofwhichtwoaretheexperimentingdrugsofthe
presentstudy,namely,amorolfineandclotrimazole.Thepatientswereinstructedtoapplytheallocated
creamtwicedailyfor4weeks.Thoughamorolfinehasbeenrecommendedbythemanufacturerforonce
dailyuse,wehaverecommendeditsuseinthestudypatientstwicedailyforthepurposeofblindingthe
evaluationofitseffectivityandadverseeffects.
Thepatientswerescheduledforexaminationbytheinvestigatorfourtimesduringthetrial.Afterthe
baselinevisit,patientswereaskedtoreportagainonday14,day28andonday56forfollowuptolook
foranyrelapse.Wetriedtosingleblindthestudybyengaginganinvestigatorforevaluatingthepatients
duringselectionandfollowup,butwaskeptblindedregardingthemoleculeusedbythepatient.
Studydrugs Amorolfine0.25%creamandclotrimazole1%creamweredispensedtothepatientsaccording

torandomization.Thefirstapplicationwassupervisedandthepatientwasadvisedtousethemedication
thereafterasperthestudyschedule.
Patientsenrolledforthestudywerenotpermittedtoconcomitantlyuseanyantifungalotherthanthetrial
drugoranyothertopicalmedication.Systemicantifungalsandcorticosteroidswerealsonotpermitted.No
systemicantihistaminewasgiven.Theywereaskedtodiscontinuethedrugandreportattheearliestifany
discomfortwasfelt.
Assessmentofeffectivityandsafety

Eachsubjectwasrequiredtoattendthecliniconfouroccasionsduring

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thestudy.Inthefirstvisit,thepatientwasscreened,whichalsoservedasthebaselinevisitifthepatient
wasnotreceivinganyinteractingdrug.Otherwise,aseparatebaselinevisitwasadvisedafterappropriate
washoutperiodonwithdrawaloftheinteractingdrug.Atscreening,athoroughmedicalhistorywastaken
andclinicalexaminationofthepotentialsubjectswasdonetoassesstheirsuitabilityforparticipationinthe
study.Informedconsentwasobtained.Skinscrapingswerecollected,treatedwith10%KOHand
examinedunderthemicroscopefordeterminationoffungalelements.Routinebloodexaminationwas
donetoruleoutdiabetesoranyothercomorbidconditioninselectedcases.Thestudymedicationwas
dispensedtothesubjectfollowingrandomization,providedallinclusionandexclusioncriteriawere
satisfied.Thepatientswereinstructedtoapplythecreamthinlytotheaffectedareatwicedaily.Each
patientwasaskedtomaintainatrialdiary.
Thesecondvisitwasonday14whenthepatientwasclinicallyexaminedandcompliancedeterminedfrom
thetrialdiary.Adverseevents,ifany,wererecorded.Mycologicalexaminationwasrepeated.Asecond
doseofthestudymedicationwasdispensedifnecessary.
Duringthethirdvisitonday28,clinicalassessmentwasrepeated,compliancedetermined,adverseevents,
ifany,wererecordedandmycologicalexaminationwasalsodone.Thepatientswereinstructednotto
applyanymedicationthereafter.
Theendoftrialvisitwas4weeksthereafter,i.e.onday56frominclusionofthesubject,torecordrelapse,
ifany.Arepeatclinicalevaluationwascarriedoutandmycologicalexaminationwasdonefromthetreated
area.
Theclinicalimprovementwasassessedbasedoneffectivityparametersforevaluationofsignsand
symptoms,whichwereitching,erythemaandscaling.Theseparameterswereassessedonapredetermined
4pointscaleasabsent,mild,moderateandsevere.
Themycologicalcureratewasstudiedinpatientsofboththegroups.Absenceoffungalelementsinthe
skinscrapingmaterialconstitutedmycologicalcure.
Thephysician'sglobalclinicalassessmentofeffectivityandtolerabilitywasgradedona4pointscaleas
poor,satisfactory,goodandexcellent.
Thepatient'sassessmentregardingeffectivityandacceptabilityoftreatmentwassimilarlyrecordedona4
pointscaleaspoor,satisfactory,goodandexcellent.
Effectivitydatawereevaluatedforsubjectswhoreportedforthefollowupvisitatthe
endof4weeks.DataentrywasdoneinMicrosoftExcelSheetandanalysiswascarriedoutinEpiinfo
2002.Chisquaretestandttestwereusedaccordingtothetypeofdata.
Statisticalanalysis

Results
Amongtheselectedpatients,afterrandomization,48weregivenamorolfinecreamand51received
clotrimazolecream.
Comparisonofmeanagebetweenthegroupsdidnotshowanysignificantdifference(P=0.84).
Comparisonofmaletofemaleratiointhestudypopulationbetweenthetwogroupsalsofailedtoshow
anysignificantdifference(P=0.50).Thegroupswerethusmatchedinrespecttotheirbaseline
demographicprofile[Table1].
Ofthe51patientswhousedclotrimazolecream,6didnotturnupforfollowuponday14ortheir
compliancewasnotsatisfactory3patientsinthisgroupwerenotconsideredsuitableforevaluationon
day28forsimilarreasons.Intheamorolfinegroup,welostfourpatientsonday14andsixonday28.
Witheitherdrug,therewasclinicalimprovementinalltheeffectivityparametersonday14,withfurther
improvementcontinuingtillday28.Intheclotrimazolegroup,itchingsubsidedin71.1and95.4%ofthe
patients,erythemawasabsentin73.3and92.9%ofthepatients,andscalingsubsidedin77.8and92.9%of
thepatientsondays14and28,respectively.Similarresultswereseenintheamorolfinegroupwhere
itchingsubsidedin72.8and92.1%ofthepatients,erythemawasabsentin72.7and97.4%ofthepatients
andscalingwasabsentin59.1and92.1%ofthepatientsondays14and28,respectively[Table2].This
indicatescontinuousreductioninpatient'ssufferingwithboththedrugs.Hence,boththedrugshavegood
effectivityastopicalantifungalagents.
Betweengroupscomparisonoftheprimaryeffectivityparametersatdifferentstudypointsshowedno
significantdifferenceinanyoftheparametersbetweenthetwogroupsatanypointoftime(P>0.05)[
Table2].Thus,itcanbeinferredthatboththedrugsprovidedeffectiverelieffromthesignsandsymptoms
oftineacorporisandtherewasnodifferenceineffectivitybetweenthem.
Skinsmearforfunguswaspositiveatbaselineinallcasesinboththegroupsaspertheinclusioncriteria.
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After14daysoftreatmentwithclotrimazole,skinsmearwaspositivein14(31.1%)patientsthus,a
mycologicalcureof68.9%wasachieved.Onday28,thecureratereachedwas76.2%.Intheamorolfine
group,themycologicalcureratewas70.5%onday14and78.9%onday28.Thesedifferencesbetween
twogroupswerenotstatisticallysignificant[Table2].
Betweengroupscomparisonofphysician'sassessmentofeffectivityattheendofthestudydidnotshow
anysignificantdifference(P=0.91).Also,nosignificantdifferencecouldbedetectedbetweenthegroups
inthepatient'sassessmentofeffectivityandtolerability(0.82)[Table3].
Onlythreepatientsintheclotrimazolegroupandsixintheamorolfinegroupattendedforfollowupon
day56,i.e.4weeksafterstoppageoftreatment.Neitherthesepatientshadanysignofactivityofthe
diseasenorweretheskinscrapingsfromoldsitesfoundpositiveforfungusatthatpoint.
Onepatientintheclotrimazolegroupshowedincreasederythemaonday14.Thepatientcontinued
applicationwithoutimprovementuptoday28.Barringthispatient,noneexperiencedanyuntowardeffect
withthemedications.Thus,boththemoleculesweretoleratedwell.
Discussion
Tineacorporisisasuperficialfungalinfection,significantlyprevalentinthepeoplebelongingtothe
socioeconomicstratathatourtertiarycarehospitalcatersto.Dermatophytesbelongingtothegenera
Trichophyton,EpidermophytonandMicrosporumareresponsibleformostofthesuperficialfungal
infections.Theseinfectionsoccurinbothhealthyandimmunocompromisedpatients.Earlyrecognition
andtreatmentisessentialtoreducemorbidityandpossibilityoftransmission.Themostcommon
dermatophytesthatcausetineacorporisareT.rubrum,T.mentagrophytes,M.canisandT.tonsurans.
Mycoseshavesignificantnegativesocial,psychological,occupationalandhealtheffects.Treatmentof
dermatophytosisisnotmerelyforestheticreasons.Persistentinfectionscancompromisethequalityoflife
toaremarkableextent.
Bothtopicalandsystemictherapiesareusedtotreatdermatophyteinfectionsdependinguponthesite
involvedandtypeandextentofinfection.Topicaltherapyiseffectiveforuncomplicatedtineacorporisof
mildtomoderategrades.Topicalagentsusedintheseinfectionsaretheimidazoles,allylamines,tolnafnate
andciclopirox.Theimidazoleantifungalagent,clotrimazole,hasbeenwidelyusedtopicallyforthe
treatmentofsuperficialdermatophytosisforyearstogether.[3,4]Thereisasyetnoreportofresistanceto
thisdrug.So,weselectedthisdrugtocomparetheeffectivityandsafetyoftopicalamorolfinecream
(0.25%),whichisacomparativelynewdrugfortopicaluseinuncomplicatedcasesoftineacorporis
infection.
Amorolfineisanewclassofantifungalagentshavingamechanismofactiondifferentfromthe
imidazoles.Itisaphenylpropylmorpholinederivativeandactsbyinhibitingergosterolbiosynthesisinthe
fungalcellmembrane.Alterationsinmembranesterolcontentleadtochangesinmembranepermeability
anddisruptionoffungalmetabolicprocesses.[5,6]Itactsontwodifferentenzymesinvolvedinsterol
biosynthesis,whichresultsindepletionofergosterol.Thisdualmechanismofactionmakesamorolfinea
potentfungistaticandfungicidalagent.Invitrostudieshavedemonstratedthatatconcentrationsof0.1
100g/ml,topicalamorolfineinducesvaryingdegreesofdamagetothenuclear,mitochondrialandplasma
membranesofbothTmentagrophytesandCandidaalbicans.[11]Aninvitrostudyhasshowntopical
amorolfinetohavethelowestminimuminhibitoryconcentration(MIC)againstvariousstrainsof
dermatophytesascomparedtoothertopicalantifungalagents.[12]
Acomparativestudyhasalsoshownamorolfinetohavemoreeffectivefungistaticandfungicidalaction
thanbifonazoleandcyclopiroxolamineinaninvitrostudywithT.rubrumcollectedfromonychomycosis
samples.[13]Amorolfineusedincombinationwithotherantifungalagentslikeketoconazole,terbinafine,
itraconazoleandfluconazolehasbeenseentocauseincreaseinfungistaticactivityagainstT.
mentagrophytes.[14]Therearemultiplestudiestodemonstratetheefficacyoftopicalamorolfinein
onychomycosis.[8,9,15]Aclinicalstudydemonstratedcomparableeffectivityofamorolfineand
bifonazoleinthetreatmentofdermatomycosis.[10]
Thisstudycomparedtheeffectivityandsafetyoftopicalamorolfineincasesofmildtomoderategradesof
tineacorporis,totheconventionaltopicalpreparationofclotrimazole.Theresultsshowthatboththedrugs
areequallyeffectiveinbringingaboutclinicalcure,withnosignificantdifferenceatanypointoffollow
up.
Withclotrimazole,itchingsubsidedin71.1%ofthepatientsonday14andin95.4%ofthepatientsonday
28.Clinicalimprovementwasseenalsoinerythemaandscalingonday14,withfurtherimprovementon
day28.Scalingpersistedin7.10%patientsinthisgroupevenonday28.Thiscanbejustifiedasscalingis
asignofhealing.Thus,withclotrimazole,gradualclinicalimprovementwasseencontinuingupto4
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weeks.
Withamorolfine,itchingsubsidedin72.8%ofthepatientsonday14andin92.1%ofthepatientsonday
28.Erythemasubsidedin72.7%ofthepatientsonday14andstillfurtherin97.4%ofthepatientsonday
28.Scalingpersistedin7.9%ofthepatientsonday28.Thus,amorolfineisalsoseentobeeffectiveasa
topicalantifungalintineacorporisandtheclinicalimprovementherealsocontinuedafterday14.
Betweengroupscomparisonsoftheeffectivityparametersforclinicalimprovementshowednosignificant
differenceinanyoftheparametersatbaseline,suggestingthattheintensityofthediseaseprocesswas
similarinboththegroups[Table2].Similarcomparisonsonthedaysofevaluation,i.e.day14andday28,
failedtoshowanysignificantdifferencebetweenthegroups.
Thus,itcanbeinferredthatboththedrugsprovidedeffectiverelieffromthesignsandsymptomsoftinea
corporisthoughtherewasnostatisticallydetectabledifferenceineffectivitybetweenthem.
Themycologicalcureratedidnotshowanysignificantdifferencebetweenthetwogroupseitheronday14
oronday28.Withclotrimazole,mycologicalcurerateachievedonday28was76.2%.Thisisatparwith
theresultofapreviousstudydonewithclotrimazole1%cream.[16]Theamorolfinegroupshoweda
mycologicalcurerateof78.9%onday28.Thisisclosetotheresultsobtainedinacomparativestudyof
amorolfinecream,donewithdifferentconcentrationsofthedrugusedtopically.[10]
Onepatientintheclotrimazolegrouphadincreasederythemaonday14,whichpersistedonday28.This
maybeconsideredasanadverseeventwiththeuseofclotrimazole.Withamorolfine,noneofthepatients
experiencedanylocaladverseevent.Nosystemicadverseeventwasreportedinanypatient.Hence,both
thedrugswereseentobesafefortopicaluse.Thephysicianaswellasthepatientsweresatisfiedwiththe
outcomeofeitherdrug.
Sincethenumberofpatientsreturningforfollowup4weeksafterstoppageoftreatmentwasverylowand
noneofthemshowedanysignofthedisease,wedidnotincludethemincommentingonthechanceof
relapsewitheithermolecule.
Thoughboththedrugsshowedgoodresultsagainstdermatophytosis,wefailedtofindanydifference
betweenthem.Thismaybeduetolessnumberofstudysubjects.Also,wehadalimitationthatourstudy
wasnotdoubleblindedthoughwetriedtosingleblinditbymakingtheevaluationsblinded.
Itcanbethusconcludedthatamorolfineontopicaluseiscomparableineffectivitytoclotrimazoleinthe
treatmentofmildtomoderategradesofdermatophytosis.Itisalsosafeandwelltolerated.
Footnotes
Sourceofsupport:Nil
ConflictofInterest:Nil.

References
1.WolffK,GoldsmithLA,KatzSI,GilchrestBA,PallerAS,LeffellDJ,editors.Fitzpatricks
DermatologyinGeneralMedicine.17thed.Vol.2.NewYork:McGrawHill2008.Fungaldiseasespp.
180710.
2.MarquesSA,RoblesAM,TortoranoAM,TuculetMA,NegroniR,MendesRP.Mycosesassociated
withAIDSintheThirdworld.MedMycol.200038:26979.[PubMed:11204155]
3.CalvinOM,ThomasJL.Eczema,Psoriasis,cutaneousinfections,acneandothercommonskin
disorders.In:Fauci,Braunwald,Kasper,Hauser,Longo,Jameson,Loscalzo,editors.Harrison'sPrinciples
ofInternalMedicine.17thed.Vol.1.NewYork:McGrawHill2008.p.318.
4.StaryA,SoeltzSzoetsJ,ZieglerC,KinghornGR,RoyRB.Comparisonoftheefficacyandsafetyof
oralfluconazoleandtopicalclotrimazoleinpatientswithCandidabalanitis.GenitourinMed.199672:98
102.[PMCID:PMC1195616][PubMed:8698375]
5.SobelJD,BrookerD,SteinGE,ThomasonJL,WermelingDP,BradleyB.Singleoraldosefluconazole
comparedwithconventionalclotrimazoletopicaltherapyofCandidavaginitis.AmJObstGynaecol.
1995172:12638.
6.HariaM,BrysonMH.Amorolfine.Drugs.199549:10320.[PubMed:7705210]
7.PolakA.Modeofactionstudies.In:RyleyJF,editor.In:HandbookofExperimentalPharmacology.
ChemotherapyofFungalDiseases.Vol.96.Berlin,Heidelberg:SpringerVerlag1990.pp.15282.
8.LechaM,AlsinaM,RodriquezJM,ErenchunFR,MiradaA,RossiAB.Anopenlabelled,multicenter
studyofthecombinationofamorolfinenaillacquerandoralitraconazolecomparedwithoralitraconazole
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3276891/?report=printable

5/7

4/16/2015 COMPARATIVE EVALUATION OF EFFECTIVITY AND SAFETY OF TOPICAL AMOROLFINE AND CLOTRIMAZOLE IN THE TREATMENT OF T

aloneinthetreatmentofseveretoenailonychomycosis.CurrTherRes.200263:36679.
9.LechaM.Amorolfineanditraconazolecombinationforseveretoenailonychomyxosisresultsofan
openrandomizedtrialinSpain.BrJDermatol.2001145:216.[PubMed:11777261]
10.NoltingS,SemigG,FriedrichHK,DietzM,ReckersR,BergstraesserM.Doubleblindcomparisonof
amorolfineandbifonazoleinthetreatmentofdermatomycoses.ClinExpDermatol.199217(Suppl1):56
60.[PubMed:1458667]
11.MllerJ,PolakWyssA,MelchingerW.InfluenceofamorolfineonthemorphologyofCandida
albicansandTrichophytonmentagrophytes.ClinExpDermatol.199217(Suppl1):1825.
[PubMed:1458658]
12.FavreB,HofbauerB,HilderingKS,RyderNS.Comparisonofinvitroactivitiesof17antifungaldrugs
againstapanelof20dermatophytesbyusingamicrodilutionassay.JClinMicrobiol.200341:48179.
[PMCID:PMC254304][PubMed:14532230]
13.SchallerM,BorelliC,BergerU,SchimdtS,WeindlG,JackelA.Susceptibilitytestingofamorolfine,
bifonazoleandciclopiroxolamineagainstTrichophytonrubruminaninvitromodelofdermatophytenail
infection.MedMycol.200947:7538.[PubMed:19888808]
14.PolakA.Combinationofamorolfinewithvariousantifungaldrugsindermatophytosis.Mycoses.
199336:439.[PubMed:8316261]
15.HariaM,BrysonHM.Amorolfine.Areviewofitspharmacologicalpropertiesandtherapeutic
potentialinthetreatmentofonychomycosisandothersuperficialfungalinfections.Drugs.199549:103
20.[PubMed:7705210]
16.BarnetsonRS,MarleyJ,BullenM,BrookmanS,CowenP,EllisD,etal.Comparisonofoneweekof
oralterbinafine(250mg/day)withfourweeksoftreatmentwithclotrimazole1%creamininterdigital
tineapedis.BrJDeramatol.1998139:6758.
FiguresandTables
Table1

Baselinedemographicprofileinthetwogroups
Table2

Distributionofsubjectsaccordingtoparametersatdifferentpointsoftimeinthetwotreatmentgroups
Table3

Globalassessmentofphysicianandpatientsattheendofstudy
ArticlesfromIndianJournalofDermatologyareprovidedherecourtesyofMedknowPublications
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