[Treatment of onychomycosis using 40% urea with 1% bifonazole]

The rate of success in treating onychomycosis with 40% urea ointment containing 1% bifonazole, with and without oral griseofulvin, was evaluated. Most patients had onychomycosis of the toes. 11 patients (group A: 5 men and 6 women, average age 48.5) were treated locally under occlusion with the ointment until dissolution of most of the nail, and then with 1% bifonazole cream for a total of 6 months. 11 others (group B: 3 men and 8 women, average age 42.5) received, in addition, griseofulvin 500 mg/day orally during that period. Treatment with the ointment alone did not give higher cure rates than the average of reported cure rates for griseofulvin alone. However, the results of treatment with 40% urea and 1% bifonazole ointment concomitantly with oral griseofulvin seemed superior to those of either of these agents alone, with full cure, partial cure and failure in group A of 22.2, 33.3 and 44.5%, respectively, and in group B, 45.4, 27.3 and 27.3%. This therapeutic experiment should be repeated in larger series of patients.