Consensus for the Treatment of Tinea Pedis:

NewsBot · Apr 23, 2022

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Consensus for the Treatment of Tinea Pedis: A Systematic Review of Randomised Controlled Trials
Harry Ward et al
J Fungi (Basel). 2022 Mar 29;8(4):351

Objective: To systematically review literature enabling the comparison of the efficacy of pharmaceutical treatments for tinea pedis in adults.

Design: Systematic review of randomised controlled trials (RCTs) with mycological cure as the primary outcome. Secondary outcomes did include the clinical assessment of resolving infection or symptoms, duration of treatment, adverse events, adherence, and recurrence.

Eligibility criteria: Study participants suffering from only tinea pedis that were treated with a pharmaceutical treatment. The study must have been conducted using an RCT study design and recording age of the participant > 16 years of age.

Results: A total of seven studies met the inclusion criteria, involving 1042 participants. The likelihood of resolution in study participants treated with terbinafine was RR 3.9 (95% CI: 2.0-7.8) times those with a placebo. Similarly, the allylamine butenafine was effective by RR 5.3 (95% CI: 1.4-19.6) compared to a placebo. Butenafine was similarly efficacious to terbinafine RR 1.3 (95% CI: 0.4-4.4). Terbinafine was marginally more efficacious than itraconazole, RR 1.3 (95% CI: 1.1-1.5).

Summary/conclusion: Topical terbinafine and butenafine treatments of tinea pedis were more efficacious than placebo. Tableted terbinafine and itraconazole administered orally were efficacious in the drug treatment of tinea pedis fungal infection. We are concerned about how few studies were available that reported the baseline characteristics for each treatment arm and that did not suffer greater than 20% loss to follow-up. We would like to see improved reporting of clinical trials in academic literature.
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NewsBot · Apr 23, 2022

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Risk factors for tinea pedis

NewsBot · Jun 8, 2022

Comparative Analysis of Tinea Pedis Treatments
Daniel Ahdoot, B.S. and Sean Lee, M.S., B.A.
Extremitas

Objective: To perform a literature review on relevant studies regarding the efficacy of different tinea pedis treatments,
and to compare various antifungal treatments, including novel fungicides to a common ergosterol synthesis inhibitor
allylamine, Terbinafine.
Methods: Relevant research found through PubMed, Google Scholar, and Western University Pumerantz Library
database. Key words like “tinea pedis treatment” and “athlete’s foot” were used to find relevant literature.
Results: Terbinafine resolved tinea pedis at a higher percentage than placebo treatments. While clotrimazole showed
promising results, terbinafine was shown to have greater efficacy (negative direct and culture mycology, as well as
two or less symptoms of tinea pedis) when compared to clotrimazole. Moreover, terbinafine yielded better results in
treating tinea pedis than griseofulvin.
Conclusion: Terbinafine appears to be the most effective drug for tinea pedis treatment. Cream treatments are more
heavily researched and are the preferred treatment type, but oral treatment may be effective as well. Hydrogel may be
added to cream treatment to improve efficacy.
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NewsBot · Aug 3, 2023

Tinea pedis: an updated review
Alexander Kc Leung et al
Drugs Context. 2023 Jun 29;12:2023-5-1

Background: Tinea pedis is one of the most common superficial fungal infections of the skin, with various clinical manifestations. This review aims to familiarize physicians with the clinical features, diagnosis and management of tinea pedis.

Methods: A search was conducted in April 2023 in PubMed Clinical Queries using the key terms 'tinea pedis' OR 'athlete's foot'. The search strategy included all clinical trials, observational studies and reviews published in English within the past 10 years.

Results: Tinea pedis is most often caused by Trichophyton rubrum and Trichophyton interdigitale. It is estimated that approximately 3% of the world population have tinea pedis. The prevalence is higher in adolescents and adults than in children. The peak age incidence is between 16 and 45 years of age. Tinea pedis is more common amongst males than females. Transmission amongst family members is the most common route, and transmission can also occur through indirect contact with contaminated belongings of the affected patient. Three main clinical forms of tinea pedis are recognized: interdigital, hyperkeratotic (moccasin-type) and vesiculobullous (inflammatory). The accuracy of clinical diagnosis of tinea pedis is low. A KOH wet-mount examination of skin scrapings of the active border of the lesion is recommended as a point-of-care testing. The diagnosis can be confirmed, if necessary, by fungal culture or culture-independent molecular tools of skin scrapings. Superficial or localized tinea pedis usually responds to topical antifungal therapy. Oral antifungal therapy should be reserved for severe disease, failed topical antifungal therapy, concomitant presence of onychomycosis or in immunocompromised patients.

Conclusion: Topical antifungal therapy (once to twice daily for 1-6 weeks) is the mainstay of treatment for superficial or localized tinea pedis. Examples of topical antifungal agents include allylamines (e.g. terbinafine), azoles (e.g. ketoconazole), benzylamine, ciclopirox, tolnaftate and amorolfine. Oral antifungal agents used for the treatment of tinea pedis include terbinafine, itraconazole and fluconazole. Combined therapy with topical and oral antifungals may increase the cure rate. The prognosis is good with appropriate antifungal treatment. Untreated, the lesions may persist and progress.
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