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July 5, 1995

The Cost of Topical Drugs for Dermatophyte Infections

Author Affiliations

Johns Hopkins Medical Institutions Baltimore, Md

JAMA. 1995;274(1):27. doi:10.1001/jama.1995.03530010041031

To the Editor.  —The article by Drs Chren and Landefeld1 was very good; however, the authors should note that clotrimazole is now available over the counter (Lotrimin AFR, Mycelex OTCR, as well as store brands). Twenty-four to 30-gram tubes of these products can be purchased in local drug stores in Baltimore, Md, for $7 to $15.It may be that the most cost-effective way for a physician to treat dermatophyte infections not involving scalp and nails is with the recommendation of an over-the-counter clotrimazole product, as well as a prescription for a different antifungal cream if the skin does not clear within a month. Finally, it is important for the physician to recommend further followup or referral to a dermatologist if the prescription cream is also unsuccessful in clearing the infection. Potassium hydroxide wet mount or fungal culture of skin scale, skin biopsy, or patch testing for allergic contact

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