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March 1977

Topical Therapy for Onychomycosis

Arch Dermatol. 1977;113(3):378. doi:10.1001/archderm.1977.01640030124032

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To the Editor.—  Chronic onychomycosis generally has required oral antifungal agents for therapy. The introduction of flucytosine for the treatment of systemic and topical fungal diseases has prompted the use of another fluorinated pyrimidine, fluorouracil (5FU), in the treatment of onychomycosis. Fluorouracil, in addition to being effective in the treatment of actinic keratoses, has also been shown to be effective for psoriasis of the nails (110:735, 1974).Briefly, patients were entered into a double-blind study of a solution containing 1% fluorouracil in propylene glycol vs placebo solution (propylene glycol) with proved onychomycosis (as made evident by potassium hydroxide preparation and culture on Sabouraud agar). Three-week intervals were allowed between visits. Photographs were taken of the affected nails in addition to the laboratory tests. At the end of 12 weeks of therapy, a decision was made as to whether the patient had been receiving the "active" medication or the "placebo" medication

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