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February 1962

Therapy of Onychomycosis by Nail Avulsion and Topically Applied Griseofulvin

Author Affiliations


From the Department of Dermatology, Walter Reed Army Institute of Research, Washington, D.C. (Capt. Demis), and the Department of Dermatology, The George Washington University Medical School, Washington, D.C. (Dr. Brown).

Arch Dermatol. 1962;85(2):276-278. doi:10.1001/archderm.1962.01590020116015

Prior to the development and introduction of griseofulvin, ringworm infections of the nails were almost completely resistant to therapy.1 Griseofulvin has proven an effective agent in the therapy of onychomycosis; however, when it is administered orally, infections of the fingernails require 6 to 9 months of therapy with the drug and toenail infections require 12 to 18 months or longer. This form of treatment has additional disadvantages, for while the cure rate approximates 90% for fingernails, the cure rate for toenails is probably closer to 10%. Moreover, the prolonged oral dosage is expensive, and, as in any systemic medication, the problems of intolerance, sensitization, untoward reactions, and potential toxicity are present.

This is a preliminary report of our experience with the topical use of griseofulvin for onychomycosis after surgical avulsion of the nail. This technique was adopted for trial when intolerance to griseofulvin developed after oral administration over prolonged periods.