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Meta-Analysis
. 2014 Aug 4;2014(8):CD009992.
doi: 10.1002/14651858.CD009992.pub2.

Topical antifungal treatments for tinea cruris and tinea corporis

Magdy El-Gohary  1 , Esther J van Zuuren, Zbys Fedorowicz, Hana Burgess, Liz Doney, Beth Stuart, Michael Moore, Paul Little
Affiliations
Meta-Analysis

Topical antifungal treatments for tinea cruris and tinea corporis

Magdy El-Gohary et al. Cochrane Database Syst Rev. .

Abstract

Background: Tinea infections are fungal infections of the skin caused by dermatophytes. It is estimated that 10% to 20% of the world population is affected by fungal skin infections. Sites of infection vary according to geographical location, the organism involved, and environmental and cultural differences. Both tinea corporis, also referred to as 'ringworm' and tinea cruris or 'jock itch' are conditions frequently seen by primary care doctors and dermatologists. The diagnosis can be made on clinical appearance and can be confirmed by microscopy or culture. A wide range of topical antifungal drugs are used to treat these superficial dermatomycoses, but it is unclear which are the most effective.

Objectives: To assess the effects of topical antifungal treatments in tinea cruris and tinea corporis.

Search methods: We searched the following databases up to 13th August 2013: the Cochrane Skin Group Specialised Register, CENTRAL in The Cochrane Library (2013, Issue 7), MEDLINE (from 1946), EMBASE (from 1974), and LILACS (from 1982). We also searched five trials registers, and checked the reference lists of included and excluded studies for further references to relevant randomised controlled trials. We handsearched the journal Mycoses from 1957 to 1990.

Selection criteria: Randomised controlled trials in people with proven dermatophyte infection of the body (tinea corporis) or groin (tinea cruris).

Data collection and analysis: Two review authors independently carried out study selection, data extraction, assessment of risk of bias, and analyses.

Main results: Of the 364 records identified, 129 studies with 18,086 participants met the inclusion criteria. Half of the studies were judged at high risk of bias with the remainder judged at unclear risk. A wide range of different comparisons were evaluated across the 129 studies, 92 in total, with azoles accounting for the majority of the interventions. Treatment duration varied from one week to two months, but in most studies this was two to four weeks. The length of follow-up varied from one week to six months. Sixty-three studies contained no usable or retrievable data mainly due to the lack of separate data for different tinea infections. Mycological and clinical cure were assessed in the majority of studies, along with adverse effects. Less than half of the studies assessed disease relapse, and hardly any of them assessed duration until clinical cure, or participant-judged cure. The quality of the body of evidence was rated as low to very low for the different outcomes.Data for several outcomes for two individual treatments were pooled. Across five studies, significantly higher clinical cure rates were seen in participants treated with terbinafine compared to placebo (risk ratio (RR) 4.51, 95% confidence interval (CI) 3.10 to 6.56, number needed to treat (NNT) 3, 95% CI 2 to 4). The quality of evidence for this outcome was rated as low. Data for mycological cure for terbinafine could not be pooled due to substantial heterogeneity.Mycological cure rates favoured naftifine 1% compared to placebo across three studies (RR 2.38, 95% CI 1.80 to 3.14, NNT 3, 95% CI 2 to 4) with the quality of evidence rated as low. In one study, naftifine 1% was more effective than placebo in achieving clinical cure (RR 2.42, 95% CI 1.41 to 4.16, NNT 3, 95% CI 2 to 5) with the quality of evidence rated as low.Across two studies, mycological cure rates favoured clotrimazole 1% compared to placebo (RR 2.87, 95% CI 2.28 to 3.62, NNT 2, 95% CI 2 to 3).Data for several outcomes were pooled for three comparisons between different classes of treatment. There was no difference in mycological cure between azoles and benzylamines (RR 1.01, 95% CI 0.94 to 1.07). The quality of the evidence was rated as low for this comparison. Substantial heterogeneity precluded the pooling of data for mycological and clinical cure when comparing azoles and allylamines. Azoles were slightly less effective in achieving clinical cure compared to azole and steroid combination creams immediately at the end of treatment (RR 0.67, 95% CI 0.53 to 0.84, NNT 6, 95% CI 5 to 13), but there was no difference in mycological cure rate (RR 0.99, 95% CI 0.93 to 1.05). The quality of evidence for these two outcomes was rated as low for mycological cure and very low for clinical cure.All of the treatments that were examined appeared to be effective, but most comparisons were evaluated in single studies. There was no evidence for a difference in cure rates between tinea cruris and tinea corporis. Adverse effects were minimal - mainly irritation and burning; results were generally imprecise between active interventions and placebo, and between different classes of treatment.

Authors' conclusions: The pooled data suggest that the individual treatments terbinafine and naftifine are effective. Adverse effects were generally mild and reported infrequently. A substantial number of the studies were more than 20 years old and of unclear or high risk of bias; there is however, some evidence that other topical antifungal treatments also provide similar clinical and mycological cure rates, particularly azoles although most were evaluated in single studies.There is insufficient evidence to determine if Whitfield's ointment, a widely used agent is effective.Although combinations of topical steroids and antifungals are not currently recommended in any clinical guidelines, relevant studies included in this review reported higher clinical cure rates with similar mycological cure rates at the end of treatment, but the quality of evidence for these outcomes was rated very low due to imprecision, indirectness and risk of bias. There was insufficient evidence to confidently assess relapse rates in the individual or combination treatments.Although there was little difference between different classes of treatment in achieving cure, some interventions may be more appealing as they require fewer applications and a shorter duration of treatment. Further, high quality, adequately powered trials focusing on patient-centred outcomes, such as patient satisfaction with treatment should be considered.

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Conflict of interest statement

There are no financial conflicts of interest; the authors declare that they do not have any associations with any parties who may have vested interests in the results of this review.

Figures

1
1
Study flow diagram.
2
2
'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
3
3
'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
1.1
1.1. Analysis
Comparison 1 Clotrimazole 1% cream versus placebo cream twice daily, Outcome 1 Mycological cure.
2.1
2.1. Analysis
Comparison 2 Terbinafine 1% cream/gel once or twice daily versus placebo cream/gel once or twice daily, Outcome 1 Mycological cure.
2.2
2.2. Analysis
Comparison 2 Terbinafine 1% cream/gel once or twice daily versus placebo cream/gel once or twice daily, Outcome 2 Clinical cure.
2.3
2.3. Analysis
Comparison 2 Terbinafine 1% cream/gel once or twice daily versus placebo cream/gel once or twice daily, Outcome 3 Clinical cure (low risk of attrition bias).
2.4
2.4. Analysis
Comparison 2 Terbinafine 1% cream/gel once or twice daily versus placebo cream/gel once or twice daily, Outcome 4 Adverse effects.
2.5
2.5. Analysis
Comparison 2 Terbinafine 1% cream/gel once or twice daily versus placebo cream/gel once or twice daily, Outcome 5 Participant‐judged cure.
3.1
3.1. Analysis
Comparison 3 Naftifine 1% cream once or twice daily versus placebo cream once or twice daily, Outcome 1 Mycological cure.
3.2
3.2. Analysis
Comparison 3 Naftifine 1% cream once or twice daily versus placebo cream once or twice daily, Outcome 2 Mycological cure (low risk of attrition bias).
3.3
3.3. Analysis
Comparison 3 Naftifine 1% cream once or twice daily versus placebo cream once or twice daily, Outcome 3 Adverse effects.
4.1
4.1. Analysis
Comparison 4 Azoles versus allylamines, Outcome 1 Mycological cure.
4.2
4.2. Analysis
Comparison 4 Azoles versus allylamines, Outcome 2 Clinical cure.
4.3
4.3. Analysis
Comparison 4 Azoles versus allylamines, Outcome 3 Mycological cure (low risk of attrition bias).
4.4
4.4. Analysis
Comparison 4 Azoles versus allylamines, Outcome 4 Clinical cure (low risk of attrition bias).
4.5
4.5. Analysis
Comparison 4 Azoles versus allylamines, Outcome 5 Adverse effects.
5.1
5.1. Analysis
Comparison 5 Azole versus moderate‐potent corticosteroid/azole combination, Outcome 1 Mycological cure.
5.2
5.2. Analysis
Comparison 5 Azole versus moderate‐potent corticosteroid/azole combination, Outcome 2 Mycological cure (low risk of attrition bias).
5.3
5.3. Analysis
Comparison 5 Azole versus moderate‐potent corticosteroid/azole combination, Outcome 3 Clinical cure.
5.4
5.4. Analysis
Comparison 5 Azole versus moderate‐potent corticosteroid/azole combination, Outcome 4 Clinical cure (at end of treatment).
5.5
5.5. Analysis
Comparison 5 Azole versus moderate‐potent corticosteroid/azole combination, Outcome 5 Adverse effects.
6.1
6.1. Analysis
Comparison 6 Azoles versus benzylamines, Outcome 1 Mycological cure.
6.2
6.2. Analysis
Comparison 6 Azoles versus benzylamines, Outcome 2 Adverse effects.
See this image and copyright information in PMC

Update of

  • doi: 10.1002/14651858.CD009992

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Kalis 1996 {published data only}
    1. Kalis B, Grosshans E, Binet O, Garrel JB, Grossetête G, Jeanpierre G, et al. Oxiconazole cream versus ketoconazole cream: A prospective, randomized, double‐blind multicentric study in the treatment of tinea cruris [Oxiconazole crème versus kétoconazole crème. Etude prospective, randomisée, en double‐insu, multicentrique, dans le traitement des dermatophytoses inguinocrurales]. Annales de Dermatologie et de Venereologie 1996;123(8):447‐52. [EMBASE: 1996268459] - PubMed
Kashin 1985 {published data only}
    1. Kashin P, Phyfferoen MC, Gibbs DL. A comparative study of once versus twice daily treatment of superficial dermatophyte and yeast infections with tioconazole (1%) cream. Journal of International Medical Research 1985;13(2):88‐95. [MEDLINE: ] - PubMed
Katz 1972 {published data only}
    1. Katz R, Cahn B. Haloprogin therapy for dermatophyte infections. Archives of Dermatology 1972;106(6):837‐8. [MEDLINE: ] - PubMed
Katz 1984 {published data only}
    1. Katz HI, Bard J, Cole GW, Fischer S, McCormick GE, Medansky RS, et al. SCH 370 (clotrimazole‐betamethasone dipropionate) cream in patients with tinea cruris or tinea corporis. Cutis 1984;34(2):183‐8. [MEDLINE: ] - PubMed
Keczkes 1975 {published data only}
    1. Keczkes K, Leighton I, Good CS. Topical treatment of dermatophytoses and candidoses. Practitioner 1975;214(1281):412‐7. - PubMed
Kokoschka 1986 {published data only}
    1. Kokoschka EM, Niebauer G, Mounari M, Monici Preti P. Treatment of dermatomycoses with topical fenticonazole and econazole [Lokalbehandlung von Dermatomykosen mit fenticonazol und econazol]. Mykosen 1986;29(1):45‐50. [MEDLINE: ] - PubMed
Kuhlwein 1990 {published data only}
    1. Kuhlwein A, Busch T. No English Title [Tinea inguinalis und tinea pedis: cruconazol versus bifonazol in der Lokaltherapie]. Therapiewoche 1990;40:1643‐5.
Lassus 1983 {published data only}
    1. Lassus A, Forström S, Salo O. A double‐blind comparison of sulconazole nitrate 1% cream with clotrimazole 1% cream in the treatment of dermatophytoses. British Journal of Dermatology 1983;108(2):195‐8. [MEDLINE: ] - PubMed
Lassus 1984 {published data only}
    1. Lassus A, Forsström S. A double‐blind parallel study comparing sulconazole with econazole in the treatment of dermatophytoses [Eine vergleichende Doppelblindstudie mit Sulconazol und Econazol in der Behandlung von Dermatophytosen]. Mykosen 1984;27(12):592‐8. [MEDLINE: ] - PubMed
Lassus 1988 {published data only}
    1. Lassus A, Nolting KS, Savopoulos C. Comparison of ciclopirox olamine 1% cream with ciclopirox 1%‐hydrocortisone acetate 1% cream in the treatment of inflamed superficial mycoses. Clinical Therapeutics 1988;10(5):594‐9. [MEDLINE: ] - PubMed
Lebwohl 1998 {published data only}
    1. Lebwohl M, Foged EK, Karvonen J, James IG, Grosshans E, Heerden JS, et al. Terbinafine (1%) solution and emulsion gel: two new formulations in one week treatment of tinea pedis and tinea corporis/cruris (Abstract P218). The 7th Congress of the European Academy of Dermatology and Venereology, Nice, 7‐11 Ocober 1998. Journal of the European Academy of Dermatology & Venereology 1998;11(Suppl 2):S237.
Lebwohl 2001 {published data only}
    1. Lebwohl M, Elewski B, Eisen D, Savin RC. Efficacy and safety of terbinafine 1% solution in the treatment of interdigital tinea pedis and tinea corporis or tinea cruris. Cutis 2001;67(3):261‐6. [PUBMED: 11270304] - PubMed
Ledezma 1999 {published data only}
    1. Ledezma E, López JC, Marin P, Romero H, Ferrara G, Sousa L, et al. Ajoene in the topical short‐term treatment of tinea cruris and tinea corporis in humans. Randomized comparative study with terbinafine. Arzneimittel‐Forschung 1999;49(6):544‐7. [MEDLINE: ] - PubMed
Leiste 1989 {published data only}
    1. Leiste D, Braun W, Fegeler W, Fegeler K, Stary A, Ruping KW, et al. A double‐blind clinical trial of fenticonazole (2%) spray versus naftifine (1%) spray in patients with cutaneous mycoses. Current Medical Research & Opinion 1989;11(9):567‐75. [MEDLINE: ] - PubMed
Lesher 1997 {published data only}
    1. Lesher JL, Babel DE, Stewart DM, Jones TM, Kaminester L, Goldman M, et al. Butenafine 1% cream in the treatment of tinea cruris: a multicenter, vehicle‐controlled, double‐blind trial. Journal of the American Academy of Dermatology 1997;36(2 Pt 1):S20‐4. [MEDLINE: ] - PubMed
Li 2003 {published data only}
    1. Li R, Liu W, Zeng F, Wang A. Assessment of the efficacy and safety of amorolfine cream vs. bifonazole cream, in the treatment of tinea corporis/cruris (Abstract P22‐15). The 12th Congress of the European Academy of Dermatology and Venereology. Barcelona, Spain 15‐18th October 2003. Journal of the European Academy of Dermatology & Venereology 2003;17(Suppl 3):319.
Li 2004 {published data only}
    1. Li Q, Li M, Jin L, Qin LM, Gu J, Liu WD, et al. Clinical efficacy of compound econazole cream in treatment of tinea corporis, tinea inguinalis, tinea manus, tinea pedis and its safety. Pharmaceutical Care & Research (Yaoxue Fuwu Yu Yanjiu) 2004;4(1):52‐4. [EMBASE: 2004249361]
Li 2006 {published data only}
    1. Li M, Bi ZG, Gu J, Sheng YN, Zhang MH, Wang Y, et al. Clinical study of butenafine hydrochloride 1% cream in the treatment of tinea pedis, tinea corporis and tinea cruris. Journal of Clinical Dermatology 2006;35(7):471‐2. [EMBASE: 2006426871]
Luciani 1988 {published data only}
    1. Luciani P, Barba A. Double blind comparative study of 1% econazole cream and 1% bifonazole cream in the treatment of dermatomycoses [Studio comparativo in doppio cieco fra econazolo crema 1% e bifonazolo crema 1% nel trattamento delle dermatomicosi]. Giornale Italiano di Dermatologia e Venereologia 1988;123(10):LIII‐LVI. [MEDLINE: ] - PubMed
Macasaet 1991 {published data only}
    1. Macasaet EN, Pert P. Topical (1%) solution of griseofulvin in the treatment of tinea corporis. British Journal of Dermatology 1991;124(1):110‐1. [MEDLINE: ] - PubMed
Machado‐Pinto 1987 {published data only}
    1. Machado‐Pinto J, Laborne MS. The use of oxiconazole 1% cream in the treatment of dermatophytoses [Uso do creme de oxiconazol a 1% no tratamento de dermatofitoses]. A Folha Médica 1987;95(5‐6):381‐4.
McVie 1986 {published data only}
    1. McVie DH, Littlewood S, Allen BR, Pollock AC, Wood P, Milne LJ. Sulconazole versus clotrimazole in the treatment of dermatophytosis. Clinical & Experimental Dermatology 1986;11(6):613‐8. [MEDLINE: ] - PubMed
Meinicke 1987 {published data only}
    1. Meinicke K, Striegel C, Weidinger G. Treatment of dermatomycoses with naftifine therapeutic efficacy on application once daily and twice daily. Mykosen 1987;30(Suppl 1):98‐103. - PubMed
    1. Meinicke K, Striegel C, Weidinger G. Treatment of dermatomycosis with Naftifin. Therapeutic effectiveness following once and twice daily administration [Dermatomykosebehandlung mit Naftifin. Therapeutische Wirksamkeit nach einmal und zweimal täglicher Applikation]. Mykosen 1984;27(12):608‐14. [PUBMED: 6395017] - PubMed
Mertens 1976 {published data only}
    1. Mertens RL, Morias J, Verhamme G. A double‐blind study comparing Daktacort, miconazole and hydrocortisone in inflammatory skin infections. Dermatologica 1976;153(4):228‐35. [MEDLINE: ] - PubMed
Millikan 1988 {published data only}
    1. Millikan LE, Galen WK, Gewirtzman GB, Horwitz SN, Landow RK, Nesbitt LT Jr, et al. Naftifine cream 1% versus econazole cream 1% in the treatment of tinea cruris and tinea corporis. Journal of the American Academy of Dermatology 1988;18(1 Pt 1):52‐6. [MEDLINE: ] - PubMed
Millikan 1990 {published data only}
    1. Millikan LE. Efficacy and tolerability of topical terbinafine in the treatment of tinea cruris. Journal of the American Academy of Dermatology 1990;23(4 Pt 2):795‐9. [MEDLINE: ] - PubMed
Miura 1979 {published data only}
    1. Miura Y, Onuki M, Takahashi S, Seiji M, Sato A, Kagawa S, et al. A double‐blind study on utility of econazole cream in dermatomycosis. Rinsho Hyoka (Clinical Evaluation) 1979;7(1):83‐108.
Nolting 1980 {published data only}
    1. Nolting S, Langen ML. Are topical corticosteroids advantageous and justifiable in the treatment of dermatomycoses (Travocort® cream and Travogen® cream were compared in 100 patients in an inter‐individual double‐blind trial [Ist der Einsatz von Kortikosteroiden in der Therapie von Dermatomykosen sinnvoll? (Travocort® Creme und Travogen® Creme im interindividuellen Vergleich an 100 Patienten)]. Mykosen 1980;23(12):699‐706. - PubMed
Nolting 1985 {published data only}
    1. Nolting S, Weidinger G. Naftifine in severe dermatomycoses: econazole‐controlled therapeutic comparison. Mykosen 1987;30(Suppl 1):70‐7. - PubMed
    1. Nolting S, Weidinger G. Naftifine in severe dermatomycosis‐econazole‐controlled therapeutic comparison [Naftifin bei schweren Dermatomykosen‐Kontrollierter Wirkungsvergleich mit Econazol]. Mykosen 1985;28(2):69‐76. [EMBASE: 1985082732] - PubMed
Nolting 1992 {published data only}
    1. Nolting S. Double‐blind, randomized study comparing three concentrations (0.125%, 0.25%, 0.5%) of RO‐14‐ 4767 and bifonazole 1% in patients with dermatomycoses. Congress of the International Society for Human and Animal Mycology. Barcelona, 1988:19.
    1. Nolting S, Semig G, Friedrich HK, Dietz M, Reckers‐Czaschka R, Bergstraesser M, et al. Double‐blind comparison of amorolfine and bifonazole in the treatment of dermatomycoses. Clinical & Experimental Dermatology 1992;17(Suppl 1):56‐60. [MEDLINE: ] - PubMed
Nuñez 1985 {published data only}
    1. Nuñez CR. Treatment of dermatomycoses with sulconazole nitrate 1% cream or econazole nitrate 1% cream: a double‐blind comparative study. Advances in Therapy 1985;2(3):112‐7. [EMBASE: 1985162144]
Oladele 2010 {published data only}
    1. Oladele AT, Dairo BA, Elujoba AA, Oyelami AO. Management of superficial fungal infections with Senna alata ("alata") soap: A preliminary report. African Journal of Pharmacy & Pharmacology 2010;4(3):98‐103. [EMBASE: 2010236028]
Pariser 1995 {published data only}
    1. Pariser RJ, Pariser DM, Caro E, Gomez C, Lazan DW, Martin S, et al. Clinical and mycological effect of clotrimazole/betamethasone dipropionate cream versus ketoconazole cream in patients with tinea cruris. Journal of Dermatological Treatment 1995;6(3):173‐7. [EMBASE: 1995319730]
Parish 2011 {published data only}
    1. Parish LC, Parish JL, Routh HB, Avakian E, Olayinka B, Pappert EJ, et al. A double‐blind, randomized, vehicle‐controlled study evaluating the efficacy and safety of naftifine 2% cream in tinea cruris. Journal of Drugs in Dermatology 2011;10(10):1142‐7. [MEDLINE: ] - PubMed
Qadripur 1984 {published data only}
    1. Qadripur SA. Double‐blind parallel comparison of sulconazole nitrate, 1% cream and powder, with econazole, 1% cream and powder, in the treatment of cutaneous dermatophytoses. Current Therapeutic Research 1984;35(5):753‐8. [EMBASE: 1985078201]
Ramam 2003 {published data only}
    1. Ramam M, Prasad HR, Manchanda Y, Khaitan BK, Banerjee U, Mukhopadhyaya A, et al. Randomised controlled trial of topical butenafine in tinea cruris and tinea corporis. Indian Journal of Dermatology, Venereology & Leprology 2003;69(2):154‐8. [MEDLINE: ] - PubMed
Ramelet 1987 {published data only}
    1. Ramalet A, Walker‐Nasir E. Oxiconazole cream: a comparison of two treatment schedules. Chemioterapia 1987;6(2 Suppl):542‐4. [PUBMED: 3334619] - PubMed
    1. Ramelet AA, Walker‐Nasir E. One daily application of oxiconazole cream is sufficient for treating dermatomycoses. Dermatologica 1987;175(6):293‐5. [MEDLINE: ] - PubMed
Repiso Montero 2006 {published data only}
    1. Repiso Montero T, López S, Rodríguez C, Rio R, Badell A, Gratacós MR. Eberconazole 1% cream is an effective and safe alternative for dermatophytosis treatment: multicenter, randomized, double‐blind, comparative trial with miconazole 2% cream. International Journal of Dermatology 2006;45(5):600‐4. [MEDLINE: ] - PubMed
Schwarz 1978 {published data only}
    1. Schwarz KJ, Luggen H, Banninger R, Konzelmann M. Tests with Pevisone in outpatients: double‐blind study including 101 patients [Poliklinische Prüfung von Pevisone: Doppelblindstudie an 101 Patienten]. Praxis 1978;67(30):1112‐6. [MEDLINE: ] - PubMed
Sehgal 1976 {published data only}
    1. Sehgal VN. Ciclopirox: a new topical pyrodonium antimycotic agent. A double blind study in superficial dermatomycoses. British Journal of Dermatology 1976;95(1):83‐8. [MEDLINE: ] - PubMed
Sharma 2011 {published data only}
    1. Sharma A, Saple DG, Surjushe A, Rao GRR, Kura M, Ghosh S, et al. Efficacy and tolerability of sertaconazole nitrate 2% cream vs. miconazole in patients with cutaneous dermatophytosis. Mycoses 2011;54(3):217‐22. [MEDLINE: ] - PubMed
Shen 2002 {published data only}
    1. Shen WM, Hu YW, Gu HY. Econazole compound cream vs miconazole cream in treating tinea corporis & cruris. Chinese Journal of New Drugs and Clinical Remedies 2002;21(3):143‐5.
Shi 2011 {published data only}
    1. Shi JP, Zhang H, Zhang ZD, Zhang GH, Gao AL, Xiang SB. Synergistic effects of tetrandrine on the antifungal activity of topical ketoconazole cream in the treatment of dermatophytoses: a clinical trial. Chinese Journal of Integrative Medicine 2011;17(7):499‐504. [MEDLINE: ] - PubMed
Singal 2005 {published data only}
    1. Singal A, Pandhi D, Agrawal S, Das S. Comparative efficacy of topical 1% butenafine and 1% clotrimazole in tinea cruris and tinea corporis: a randomized, double‐blind trial. Journal of Dermatological Treatment 2005;16(5‐6):331‐5. [MEDLINE: ] - PubMed
Sivayathorn 1979 {published data only}
    1. Sivayathorn A, Piamphongsant T. Topical antimycotic agents for the treatment of superficial dermatophytoses in Thailand – A double‐blind study [Lokal wirksame Antimykotika für die Behandlung oberflächlicher Dermatophytosen in Thailand ‐ Eine doppfelblinde Studie]. Mykosen 1979;22(1):21‐4. [MEDLINE: ] - PubMed
Smith 1974 {published data only}
    1. Smith EB, David LM, Knox JM. Topical clotrimazole in dermatophytosis in a prison environment. Postgraduate Medical Journal 1974;50(Suppl 1):64‐6. [MEDLINE: ] - PubMed
Spiekermann 1976 {published data only}
    1. Spiekermann PH, Young MD. Clinical evaluation of clotrimazole. A broad‐spectrum antifungal agent. Archives of Dermatology 1976;112(3):350‐2. [MEDLINE: ] - PubMed
Su 2001 {published data only}
    1. Su, JG, Pan XF. The curative effect observation of compound miconazole cream in treating tinea cruris. Chinese Journal of Dermatovenereology 2001;15(5):357.
Susilo 2003 {published data only}
    1. Susilo R, Korting HC, Strauss UP, Sertaconazole Study Group. Dermatomycoses of the glabrous skin: a double‐blind, randomised, comparative trial of sertaconazole 2% cream once daily versus vehicle. Clinical Drug Investigation 2003;23(6):387‐94. [MEDLINE: ] - PubMed
Tanenbaum 1982 {published data only}
    1. Tanenbaum L, Anderson C, Rosenberg MJ, Howard W, McDaniel W, Neimanis A, et al. Sulconazole nitrate 1.0 percent cream: a comparison with miconazole in the treatment of tinea pedis and tinea cruris/corporis. Cutis 1982;30(1):105‐7. [MEDLINE: ]
Tanenbaum 1989 {published data only}
    1. Tanenbaum L, Taplin D, Lavelle C, Akers WA, Rosenberg MJ, Carmargo G. Sulconazole nitrate cream 1 percent for treating tinea cruris and corporis. Cutis 1989;44(4):344‐7. [MEDLINE: ] - PubMed
Thomas 1976 {published data only}
    1. Thomas DJ. A study in industry of clotrimazole cream in tinea pedis and tinea cruris. Current Medical Research & Opinion 1976;3(9):630‐3. [EMBASE: 0977017004]
Thomas 1986 {published data only}
    1. Thomas DJ, Evans A. A study in industry of bifonazole (1% gel) and sulconazole cream in tinea pedis and tinea cruris. In: Hay RJ editor(s). Advances in Topical Antifungal Therapy. Berlin: Springer‐Verlag, 1986:68‐75.
Thulin 1975 {published data only}
    1. Thulin H, Østerbye P. Miconazole in the treatment of dermatomycosis. Mykosen 1975;18(5):249‐53. [MEDLINE: ] - PubMed
Tronnier 1987 {published data only}
    1. Tronnier H. Inflammatory dermatomycoses ‐comparative study of naftifine and a combination of a corticosteroid and an imidazole derivative. Mykosen 1987;30(Suppl 1):78‐87.
Vander Ploeg 1984 {published data only}
    1. Vander Ploeg DE, Villez RL. A new topical antifungal drug: tioconazole. International Journal of Dermatology 1984;23(10):681‐3. [MEDLINE: ] - PubMed
VanDersarl 1977 {published data only}
    1. VanDersarl JV, Sheppard RH. Clotrimazole vs haloprogin treatment of tinea cruris. Archives of Dermatology 1977;113(9):1233‐5. [MEDLINE: ] - PubMed
van Heerden 1997 {published data only}
    1. Heerden JS, Vismer HF. Tinea corporis/cruris: new treatment options. Dermatology 1997;194(Suppl 1):14‐8. [MEDLINE: ] - PubMed
Vannini 1988 {published data only}
    1. Vannini P, Difonzo EM, Cordaro CI, Sartani A, Panconesi E. New therapeutic approach in skin mycoses: a comparative trial once versus twice daily applications of fenticonazole in comparison to miconazole [Neuer Therapieansatz bei Hautmykosen: Studie über die tägliche Einmal‐ und Zweimal‐anwendung von Fenticonazol im Vergleich mit Miconazol]. Mycoses 1988;31(5):280‐4. - PubMed
Vena 1983 {published data only}
    1. Vena GA, Barile F, Faravelli M, Angelini G. Efficacy and safety of bifonazole (BAY h 4502) in patients with pityriasis versicolor and tinea cruris [Zur Wirkzamkeit und Verträglichkeit von Bifonazol (BAY h 4502) bei Patienten mit Pityriasis versicolor und Tinea inguinalis]. Mykosen 1983;26(8):415‐20. [MEDLINE: ] - PubMed
Viayna 2003 {published data only}
    1. Viayna C, Álvarez D, Domper N, Puerta L, Martínez D, López R. Eberconazole 1% cream in the treatment of dermatophytosis: double‐blind, randomised comparative trial with miconazole 2% cream (Abstract FC1‐10). The 12th Congress of the European Academy of Dermatology and Venereology. Barcelona, Spain15‐18th October. Journal of the European Academy of Dermatology & Venereology 2003;17(Suppl 3):14.
Voravutinon 1993 {published data only}
    1. Voravutinon V. A randomized comparative study in treatment of tinea corporis, tinea cruris with whitfield's ointment and miconazole cream. Thai Journal of Dermatology 1993;9(1):1‐10.
Wagner 1987 {published data only}
    1. Wagner W, Reckers‐Czaschka R. Oxiconazole in dermatomycosis ‐a double‐blind, randomized comparison with bifonazole [Oxiconazol bei Dermatomykosen – ein Doppelblinder, randomisierter Therapievergleich mit Bifonazol]. Mykosen 1987;30(10):484‐92. [PUBMED: 3325843] - PubMed
Wang 1995 {published data only}
    1. Wang AP, Li ZY, Wang DL, Ma SQ, Zhou ZD, Wan Z. The clinical Lamisil cream for body and tinea cruris (Chinese). Journal of Clinical Dermatology 1995;24(2):100‐1.
Wang 2000 {published data only}
    1. Wang KY, Li CY, Liang LP. A randomized controlled clinical study of terbinafine powder versus miconazole for the treatment of tinea manum/pedis and tinea corporis/cruris. Chinese Journal of Clinical Pharmacology 2000;16(4):265‐8.
Wang 2000a {published data only}
    1. Wang AP, Li RY, Shun QN, Wan Z, Wang XH, Wang JB, et al. A double blind randomized controlled clinical trial of econazole‐triamcinolon acetonide cream in the treatment of tinea pedis and tinea corporis & cruris. Chinese Journal of Clinical Pharmacology 2000;16(5):345‐9.
Weitgasser 1977 {published data only}
    1. Weitgasser H. Clinical and myocological study of the antifungal agent haloprogin [Klinische und mykologische Untersuchungen mit dem Antimykotikum Haloprogin]. Mykosen 1977;20(1):15‐24. [MEDLINE: ] - PubMed
Wortzel 1982 {published data only}
    1. Wortzel MH. A double‐blind study comparing the superiority of a combination antifungal (clotrimazole)/steroidal (betamethasone dipropionate) product. Cutis 1982;30(2):258‐61. [MEDLINE: ] - PubMed
Yim 2010 {published data only}
    1. Yim SM, Ko JH, Lee YW, Kim HW, Lee JY, Kim NI, et al. Study to compare the efficacy and safety of fluconazole cream with flutrimazole cream in the treatment of superficial mycosis: a multicentre, randomised, double‐blind, phase III trial. Mycoses 2010;53(6):522‐9. [MEDLINE: ] - PubMed
Zaias 1993 {published data only}
    1. Zaias N, Berman B, Cordero CN, Hernandez A, Jacobson C, Millikan L, et al. Efficacy of a 1‐week, once‐daily regimen of terbinafine 1% cream in the treatment of tinea cruris and tinea corporis. Journal of the American Academy of Dermatology 1993;29(4):646‐8. [MEDLINE: ] - PubMed
Zarowny 1975 {published data only}
    1. Zarowny DP, Rogers RS, Tindall JP. Evaluation of the effectiveness of griseofulvin, tolnaftate, and placebo in the topical therapy of superficial dermatophytoses. Journal of Investigative Dermatology 1975;64(4):268‐72. [MEDLINE: ] - PubMed
Zaun 1984 {published data only}
    1. Zaun H, Luszpinski P. Antifungal treatment of hospital inpatients ‐'left versus right' study to compare naftifine and clotrimazole. Mykosen 1987;30(Suppl 1):42‐8.
    1. Zaun H, Luszpinski P. Multicenter double‐blind contralateral comparison of naftifin and clotrimazole cream in patients with dermatophytosis and candidiasis [Multizentrischer doppelblinder Halbseitenvergleich von naftifin‐und clotrimazol‐Creme bei Patienten mit Dermatophytosen und Candidosen]. Zeitschrift für Hautkrankheiten 1984;59(18):1209‐17. [PUBMED: 6388169] - PubMed

References to studies excluded from this review

Anderson 2012 {published data only}
    1. Anderson BJ. Effectiveness of body wipes as an adjunct to reducing skin infections in high school wrestlers. Clinical Journal of Sport Medicine 2012;22(5):424‐9. [MEDLINE: ] - PubMed
Arnoldi 1979 {published data only}
    1. Arnoldi EG. Clinical trial with tolnaftate in the treatment of superficial mycosis [Estudio clínico com o tolnaftato no tratamento das micoses superficiais]. Revista Brasileira de Clínica e Terapêutica 1979;8(7):316‐8. [EMBASE: 1980169707]
Arreaza de Arreaza 1984 {published data only}
    1. Arreaza de Arreaza F, Díaz de Torres E, Briceño Maaz T. Double‐blind comparative study of RO‐13‐8996 with miconazole in relation to its efficiency and local tolerance in patients with dermatomycosis [Estudio comparativo doble ciego de RO‐13‐8996 con miconazole en relación a sus eficacia y tolerancia local en pacientes con dermatomicosis]. Medicina Cutánea Ibero Latino Americana 1984;12(1):57‐61. [MEDLINE: ] - PubMed
Baran 1979 {published data only}
    1. Baran R, Beurey J, Civatte J, Desmons F, Hincky M, Meynadier J, et al. Multicentric clinical trial of a new combination of a broad spectrum antimycotic and a dermocorticoid [Étude thérapeutique multicentrique d'une nouvelle association d'un antifongique a large spectre et d'un corticoïde]. La Semaine des Hôpiteaux 1979;55(5‐6):269‐72. [MEDLINE: ] - PubMed
Bonifaz 2000 {published data only}
    1. Bonifaz A, Saul A. Comparative study between terbinafine 1% emulsion‐gel versus ketoconazole 2% cream in tinea cruris and tinea corporis. European Journal of Dermatology 2000;10(2):107‐9. [MEDLINE: ] - PubMed
Comaish 1975 {published data only}
    1. Comaish JS. Double blind comparison of clotrimazole with Whitfield's and nystatin ointments. Postgraduate Medical Journal 1974;50(Suppl 1):73‐5. [MEDLINE: ] - PubMed
el Darouti 1990 {published data only}
    1. Darouti MA, Kalinka P. Naftifine cream 1% compared with miconazole cream 2% in dermatophytosis. International Journal of Dermatology 1990;29(7):521‐2. [MEDLINE: ] - PubMed
Fiorini 1991 {published data only}
    1. Fiorini JE, Fiorini CM, Pedreira RC, Faria‐e‐Silva PM, Chavasco JK. Topical application of isoconazole in the superficial mycosis treatment [Aplicação tópica do nitrato de isoconazol para o tratamento de micoses superficiais]. Revista Brasileira de Medicina 1991;48(6):344, 346‐7, 349‐50. [EMBASE: 1991251687]
Hay 1985 {published data only}
    1. Hay RJ, Clayton YM, Griffiths WA, Dowd PM. A comparative double blind study of ketoconazole and griseofulvin in dermatophytosis. British Journal of Dermatology 1985;112(6):691‐6. [MEDLINE: ] - PubMed
Kagawa 1989 {published data only}
    1. Kagawa S. Clinical efficacy of terbinafine in 629 Japanese patients with dermatomycosis. Clinical and Experimental Dermatology 1989;14(2):114‐5. [MEDLINE: ] - PubMed
Kamalam 1980 {published data only}
    1. Kamalam A, Thambiah AS. Clotrimazole and econazole in dermatophytoses (a double‐blind study) [Clotimazol und Econazol bei Dermatomykosen]. Mykosen 1980;23(12):707‐10. [MEDLINE: ] - PubMed
László 1991 {published data only}
    1. László A, Balogh G, Kohányi E, Román S. Use of Nizoral cream in dermatomycoses. Therapia Hungarica 1991;39(4):179‐82. [MEDLINE: ] - PubMed
Mathur 1973 {published data only}
    1. Mathur SM, Agarwal RK. Clinical trial of 'Jadit' in superficial mycoses. Indian Journal of Dermatology, Venereology, & Leprology 1973;39(6):266‐9. [EMBASE: 0974199232] - PubMed
Nada 1994 {published data only}
    1. Nada M, Hanafi S, al‐Omari H, Mokhtar M, el‐Shamy S, Mühlbacher J. Naftifine versus miconazole/hydrocortisone in inflammatory dermatophyte infections. International Journal of Dermatology 1994;33(8):570‐2. [MEDLINE: ] - PubMed
No authors listed 1992 {published data only}
    1. Turkish Multicenter Dermatophytosis Study Group. Naftifine treatment for dermatophytosis: multicenter clinical investigations in Turkey. International Journal of Dermatology 1992;31(4):247‐8. [MEDLINE: ] - PubMed
Saple 2001 {published data only}
    1. Saple DG, Amar AK, Ravichandran G, Korde KM, Desai A. Efficacy and safety of butenafine in superficial dermatophytoses (tinea pedis, tinea cruris, tinea corporis). Journal of the Indian Medical Association 2001;99(5):274‐5. [MEDLINE: ] - PubMed
Sartani 1988 {published data only}
    1. Sartani A, Cordaro CI, Panconesi E. A multicenter trial with a new imidazole derivative, fenticonazole, in superficial fungal skin infections. Current Therapeutic Research 1988;43(6):1194‐1203. [EMBASE: 1988173204]
Scherwitz 1977 {published data only}
    1. Scherwitz C. Clinical testing of Econazole skin lotion and cream in dermatomycoses [Klinische Prüfung von Econazol Haut‐Milch und ‐ Creme bei Hautmykosen]. Zeitschrift für Hautkrankheiten 1977;52(4):117‐25. [MEDLINE: ] - PubMed
Svejgaard 1973 {published data only}
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Szarmach 1984 {published data only}
    1. Szarmach H, Weuta H, Stepka L. Limitations of indications of clotrimazole‐hydrocortisone and its components. A double‐blind study [Indikationsabgrenzung zwischen Clotrimazol/Hydrocortison und seinen beiden Komponenten: Eine Doppelblinde Studie]. Arzneimittel‐Forschung 1984;34(8):927‐30. [PUBMED: 6388585] - PubMed
Török 1993 {published data only}
    1. Török I, Stehlich G. Double‐blind comparative examination of ketoconazole 1% cream and clotrimazole 2% ointment in superficial dermatomycosis. Therapia Hungarica 1993;41(2):60‐3. [MEDLINE: ] - PubMed
Tulli 1988 {published data only}
    1. Tulli A. Evaluation of the clinical efficacy and tolerance of a formulation of 2% tioconazole cream versus 1% tioconazole cream in the treatment of dermatomycoses [Valutazione dell'efficacia clinica e della tollerabilità di una formuliazione di tioconazolo crema 2% vs tioconazolo crema 1% nella terapia delle dermatomicosi]. Giornale Italiano di Chemioterapia 1988;35(1‐3):69‐73. [MEDLINE: ] - PubMed
Tulli 1988a {published data only}
    1. Tulli A, Leone E, Simone C. 1% tioconazole powder in the treatment of dermatomycoses [Il tioconazole 1% nel trattamento delle dermatomicosi]. La Clinica Terapeutica 1988;126(6):417‐20. [MEDLINE: ] - PubMed
Wiedey 1982 {published data only}
    1. Wiedey K, Renovanz H‐D, Maier‐Lenz H. Comparative study of therapeutic effectiveness of tolciclate and miconazole in superficial dermatophytosis and in pityriasis versicolor [Vergleichsuntersuchungen zwischen Tolciclat und Miconazol bei oberflächlichen Dermatophytien und Pityriasis versicolor]. Mykosen 1982;25(3):126‐32. [MEDLINE: ] - PubMed

References to studies awaiting assessment

Alomar 1995 {published data only}
    1. Alomar A, Videla S, Delgadillo J, Gich I, Izquierdo I, Forn J, et al. Flutrimazole 1% dermal cream in the treatment of dermatomycoses: a multicentre, double‐blind, randomized, comparative clinical trial with bifonazole 1% cream. Efficacy of flutrimazole 1% dermal cream in dermatomycoses. Catalan Flutrimazole Study Group. Dermatology 1995;190(4):295‐300. [EMBASE: 1995164602] - PubMed
Binet 1994 {published data only}
    1. Binet O, Soto‐Melo J, Delgadillo J, Videla S, Izquierdo I, Forn J, et al. Flutrimazole 1% dermal cream in the treatment of dermatomycosis: a randomized, multicentre, double‐blind, comparative clinical trial with 1% clotrimazole cream. Flutrimazole Study Group [Flutrimazol‐Creme (1%) zur Behandlung von Dermatomykosen: Eine randomisierte, multizentrische, gegen Clotrimazol‐Creme (1%) im Vergleich durchgeführte Doppelblindstudie]. Mycoses 1994;37(11‐12):455‐59. [EMBASE: 1995163523] - PubMed
Choudhary 2013 {published data only}
    1. Choudhary S, Bisati S, Singh A, Koley S. Efficacy and safety of terbinafine hydrochloride 1% cream vs. sertaconazole nitrate 2% cream in tinea corporis and tinea cruris: a comparative therapeutic trial. Indian Journal of Dermatology 2013;58(6):457‐60. [PUBMED: PMID: 24249898 ] - PMC - PubMed
el Darouti 1989 {published data only}
    1. Darouti MA, al Raubaie S, Shandrashekhar CR, al Sawaf MH, Movahadi GA. Double‐blind randomized comparative study of naftifine cream and clotrimazole cream in the treatment of dermatophytosis. International Journal of Dermatology 1989;28(5):345‐6. [EMBASE: 1989179688] - PubMed
Fredriksson 1974 {published data only}
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Gooskens 1994 {published data only}
    1. Gooskens V, Pönnighaus JM, Clayton Y, Mkandawire P, Sterne JA. Treatment of superficial mycoses in the tropics: Whitfield's ointment versus clotrimazole. International Journal of Dermatology 1994;33(10):738‐42. [EMBASE: 1994316701] - PubMed
Jones 2014 {published data only}
    1. Jones TM, Jarratt MT, Mendez‐Moguel I, Paz N, Grekin SK, Cognata Smith C, et al. A randomized, multicenter, double‐blind, vehicle‐controlled study evaluating the efficacy and safety of luliconazole cream 1% once daily for 7 days in patients aged ≥ 12 years with tinea cruris. Journal of Drugs in Dermatology 2014;13(1):32‐8. [PUBMED: PMID: 24385117] - PubMed
    1. Jones TM, Smith CC, Kaur M, Jarett MT, Grekin SK. A randomized, multicenter, double‐blind, vehicle‐controlled study evaluating the efficacy and safety of luliconazole cream 1% once daily for 7 days in adults with tinea cruris. Journal of the American Academy of Dermatology 2014;70(5):AB107. - PubMed
Kuokkanen 1982 {published data only}
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Male 1981 {published data only}
    1. Male O. Comparison of naftifine with clotrimazole and tolnaftate in patients with superficial dermatophytoses. Current chemotherapy and immunotherapy. Proceedings of the 12th International Congress of Chemotherapy, Washington, DC: American Society of Microbiology. 1981:1019‐1021.
Nolting 1995 {published data only}
    1. Nolting S, Rogalla K. Double‐blind comparison of miconazole/corticosteroid combination versus miconazole in inflammatory dermatomycoses. International Journal of Dermatology 1995;34(2):125‐8. [EMBASE: 1995050973] - PubMed
Tamil Selvan 2013 {published data only}
    1. Tamil Selvan A, Girisha G, Vijaybhaskar, Suthakaran R. Comparative evaluation of newer topical antifungal agents in the treatment of superficial fungal infections (tinea or dermatophytic). International Research Journal of Pharmacy 2013;4(6):224‐8. [EMBASE: 2013588560]
Thaker 2013 {published data only}
    1. Thaker SJ, Mehta DS, Shah HA, Dave JN, Mundhava SG. A comparative randomized open label study to evaluate efficacy, safety and cost effectiveness between topical 2% sertaconazole and topical 1% butenafine in tinea infections of skin. Indian Journal of Dermatology 2013;58(6):451‐6. [PUBMED: PMID: 24249897] - PMC - PubMed

References to ongoing studies

CTRI/2009/091/000679 {published data only}
    1. CTRI/2009/091/000679. A clinical trial to study the effects of two drugs, naftifine and terbinafine in patients with dermatophytosis. www.ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=867 (accessed 1 June 2014).
CTRI/2009/091/001025 {published data only}
    1. CTRI/2009/091/001025. A clinical trial in patients with Tinea pedis and Tinea cruris. Clinical trial is to study efficacy, safety and tolerability of Naftifine Hydrochloride 1% cream in comparison to Terbinafine Hydrochloride 1% cream (reference product). www.ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=1161 (accessed 1 June 2014).
CTRI/2010/091/000178 {published data only}
    1. CTRI/2010/091/000178. A clinical trial to study the effect of a fixed dose formulation of Sertaconazole + Beclomethasone and miconazole nitrate in patients with tinea infections associated with inflammatory skin conditions. www.ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=1391 (accessed 1 June 2014).
CTRI/2012/03/002522 {published data only}
    1. CTRI/2012/03/002522. A clinical trial to study the effects of drugs Calmagen cream and lotion in patients for topical treatment of Tinea (ringworm infection). www.ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=2767 (accessed 1 June 2014).
EUCTR2005‐001239‐32 {published data only}
    1. EUCTR2005‐001239‐32. Ensayo clínico multicéntrico, aleatorizado, paralelo, doble ciego, para evaluar la eficacia y seguridad de eberconazol solución 1% frente a placebo en el tratamiento de las dermatofitosis. apps.who.int/trialsearch/trial.aspx?trialid=EUCTR2005‐001239‐32‐ES (accessed 1 June 2014).
NCT01342315 {published data only}
    1. NCT01342315 . Topical Antifungal Treatment for Tinea Cruris. clinicaltrials.gov/show/NCT01342315 (accessed 1 June 2014).
NCT01885156 {published data only}
    1. NCT01885156. Evaluation of Efficacy and Safety of Naftin 1% Cream in Adolescent Subjects With Tinea Cruris. http://clinicaltrials.gov/show/NCT01885156 (accessed 23 May 2014).

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