Terbinafine in the treatment of tinea imbricata: An open pilot study

The objective of this open parallel-group pilot study wa to assess the safety and efficacy of terbinafine (Lamisil®), a new allylamine antifungal agent, compared with griseofulvin in the treatment of tinea imbricata. The study was carried out in patients living in remote villages in the Central Kalimantan province of Indonesia. Patients entering the study had tinea imbricata due to Trichophyton concentricum, confirmed by mycological as well as clinical evaluation. A total of 55 patients were given either terbinafine at 250 mg once daily (n = 30) or griseofulvin at 500 mg once daily (n = 25) for 6 weeks, after which follow-ups were made at 2 and 5 months to assess relapse. Clinical and mycological examinations were carried out before and after treatment, and during follow-ups.All 30 patients taking terbinafine were evaluable and were completely (clinically and mycologically) cured (100%). In contrast, of the 23/25 evaluable patients taking griseofulvin, 16 (70%) were completely cured and 7 (30%) showed no response. After 2 months, follow-up showed that 2/30 (7%) in the terbinafine group and 5/16 (31%) in the griseofulvin group had relapsed. After 5 months, these relapse figures had increased to 7/27 (26%) and 5/15 (33%) in the terbinafine and griseofulvin groups respectively. Mild headache and sweating were the only side-effects reported in a smhll number of patients. No patients discontinued treatment nor were there changes in liver, kidney or haematological para-meters compared with pretreatment values. In conclusion, these results indicate that terbinafine is highly effective and well tolerated in patients with tinea imbricata.