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
Whitmore SE. The Cost of Topical Drugs for Dermatophyte Infections. JAMA. 1995;274(1):27. doi:10.1001/jama.1995.03530010041031