Clinical evaluation of bifonazole for moccasin-type tinea pedis

Moccasin-type tinea pedis (MTTP) is characterized by hyperkeratosis of the sole, which is generally refractory to treatment. As topical application of an antimycotic agent alone often fails to control this disease, oral griseofulvin is commonly used. We attempted the treatment of MTTP with topical bifonazole (Mycospor Solution) alone (group I) or in combination with 10% urea ointment (Urepearl) (group II) and compared the clinical benefit of these two therapies. The clinical improvement rate (percentage of 'marked improvement' plus 'moderate improvement') was 46.2% in group I and 83.3% in group II. The fungal eradication rate was 6.7% in group I and 26.7% in group II after 4 weeks of treatment and was 40% and 80%, respectively, after 12 weeks. The utility rate (percentage of 'beneficial' plus 'very beneficial') was 46.7% in group I and 86.7% in group II. These results indicate the superiority of combined therapy with 1% bifonazole solution and 10% urea ointment for the treatment of MTTP and suggest that this combination therapy can be recommended for patients for whom it is difficult to use oral griseofulvin or for patients who fail to respond to oral griseofulvin alone.