Interdigital tinea pedis (dermatophytosis simplex and complex) and treatment with ciclopirox 0.77% gel

Abstract

The most common presentation of tinea pedis (athlete's foot) is that involving the interdigital spaces. Tinea pedis interdigitalis may present as asymptomatic dermatophytosis simplex or dermatophytosis complex, which is symptomatic, with secondary bacterial infection. In the dermatophytosis complex presentation there may be inflammation, maceration and odor, with bacterial involvement. Ciclopirox gel offers advantages in the treatment of tinea pedis, especially in the dermatophytosis complex presentation, with antifungal, antibacterial, and anti-inflammatory activity; furthermore, the gel formulation is fast drying, which is an advantage when the toe web area is moist.

Ciclopirox: a broad‐spectrum antifungal with antibacterial and anti‐inflammatory properties

“…In the ciclopirox‐treated group, total aerobic bacterial counts had returned to baseline values at 2 weeks post‐treatment 6 . No cure rates were provided for this study, however in another study bacterial count reduction and high rates of mycological cure, clinical cure and complete cure were found in subjects with dermatophytosis complex treated with ciclopirox 0.77% gel 1 …”

“…The unique mechanism of action of ciclopirox, combined with its antibacterial and anti‐inflammatory properties, make it an ideal candidate for the treatment of superficial dermatophyte and yeast infections. This is evidenced by its success in the treatment of interdigital tinea pedis, which often presents as dermatophyte fungus with superimposed bacterial infection and inflammation 1,2 . Seborrheic dermatitis also may involve a combination of fungal infection and inflammatory action, 21 which has been successfully controlled using ciclopirox 14,15 .…”

“…Finally, the potential for resistance of organisms to ciclopirox may be lower than for other antifungals 7 . Thus ciclopirox has been used in multiple clinical trials for a wide variety of indications, and years of clinical usage have demonstrated the safety and efficacy of ciclopirox in the treatment of superficial mycoses 1,2,6,11,17,20,22–24 …”

“…In the USA, ciclopirox is available in five formulations to treat a variety of superficial mycoses including tinea pedis, tinea corporis/cruris, pityriasis (tinea) versicolor, and seborrheic dermatitis (Table 1). Ciclopirox 0.77% gel has been reported as a successful treatment for tinea pedis 1,2 . Ciclopirox 8% nail lacquer is indicated in the USA for the treatment of onychomycosis.…”

Ciclopirox gel: an update

“…In some instances the inflammatory component is marked. Gupta et al 4 . review the literature where ciclopirox has been used to treat tinea pedis.…”