Combination of fluconazole and urea in a nail lacquer for treating onychomycosis

Altogether, 13 patients with onychomycosis, aged 25-78 years, most with involvement of the matrix region, were treated. A solution of 1% fluconazole and 20% urea in a mixture of ethanol and water was applied once daily, at bedtime.

In four patients there was complete resolution of the condition; four patients who had involvement of one nail only demonstrated a 90% improvement. Of the four patients who had presented with involvement of both big toenails, two showed 50% improvement bilaterally and in the remaining two patients there was a 90% improvement in one nail and a 50% improvement in the other. One patient with proximal white subungual onychomycosis of the finger nail, who grew Alternaria, relapsed during treatment after an initial positive response.

Generally, a favourable response to local treatment may be anticipated only if the distal two-thirds of the nail is affected. In view of this, and despite the fact that most of the patients were severely affected with involvement of the proximal third of the nail, the response to local therapy was appreciable.