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Evidence based topical treatments for tinea cruris and tinea corporis: a summary of a Cochrane systematic review

Evidence based topical treatments for tinea cruris and tinea corporis: a summary of a Cochrane systematic review
Evidence based topical treatments for tinea cruris and tinea corporis: a summary of a Cochrane systematic review
Tinea cruris and tinea corporis are common fungal infections seen by both general practitioners and dermatologists. Most of these can be treated with a variety of topical antifungals. This review aimed to assess the evidence for the effectiveness and safety of topical treatments for tinea cruris and tinea corporis. Searches included: Cochrane Skin Group Specialised Register, CENTRAL in The Cochrane Library, MEDLINE, EMBASE, LILACS, and ongoing trials registries (August 2013). 129 randomised controlled trials (RCTs) with 18,086 participants evaluated a range of interventions; mostly azoles. Pooling of data for several outcomes was only possible for two individual treatments. Terbinafine in 5 studies showed a statistically significant higher clinical cure rate compared to placebo (RR 4.51, 95% CI 3.10 to 6.56). Data for mycological cure could not be pooled due to substantial heterogeneity. Mycological cure rates favoured naftifine (1%) compared to placebo across three studies (RR 2.38, 95% CI 1.80 to 3.14) but the quality of the evidence was graded low. Combinations of azoles with corticosteroids were slightly more effective than azoles for clinical cure, but there was no statistically significant difference with regard to mycological cure. 65 studies were assessed at ‘unclear’ and 64 at ‘high risk’ of bias; many were over 20 years old and most were poorly designed and inadequately reported. Although most active interventions showed sufficient therapeutic effect, this review highlights the need for further, high quality, adequately powered RCTs to evaluate the effects of these interventions which can ultimately provide reliable evidence to inform clinical decision making.
0007-0963
van Zuuren, E.J.
4fcf1cd6-bb6d-4716-906a-8b40351dbd1e
Fedorowicz, Z.
e1367a14-4897-4f52-b8d0-8ec7f44fc2df
El-Gohary, M.
392c5e6d-a761-4577-967f-2f36054aa653
van Zuuren, E.J.
4fcf1cd6-bb6d-4716-906a-8b40351dbd1e
Fedorowicz, Z.
e1367a14-4897-4f52-b8d0-8ec7f44fc2df
El-Gohary, M.
392c5e6d-a761-4577-967f-2f36054aa653

van Zuuren, E.J., Fedorowicz, Z. and El-Gohary, M. (2014) Evidence based topical treatments for tinea cruris and tinea corporis: a summary of a Cochrane systematic review. British Journal of Dermatology. (doi:10.1111/bjd.13441).

Record type: Article

Abstract

Tinea cruris and tinea corporis are common fungal infections seen by both general practitioners and dermatologists. Most of these can be treated with a variety of topical antifungals. This review aimed to assess the evidence for the effectiveness and safety of topical treatments for tinea cruris and tinea corporis. Searches included: Cochrane Skin Group Specialised Register, CENTRAL in The Cochrane Library, MEDLINE, EMBASE, LILACS, and ongoing trials registries (August 2013). 129 randomised controlled trials (RCTs) with 18,086 participants evaluated a range of interventions; mostly azoles. Pooling of data for several outcomes was only possible for two individual treatments. Terbinafine in 5 studies showed a statistically significant higher clinical cure rate compared to placebo (RR 4.51, 95% CI 3.10 to 6.56). Data for mycological cure could not be pooled due to substantial heterogeneity. Mycological cure rates favoured naftifine (1%) compared to placebo across three studies (RR 2.38, 95% CI 1.80 to 3.14) but the quality of the evidence was graded low. Combinations of azoles with corticosteroids were slightly more effective than azoles for clinical cure, but there was no statistically significant difference with regard to mycological cure. 65 studies were assessed at ‘unclear’ and 64 at ‘high risk’ of bias; many were over 20 years old and most were poorly designed and inadequately reported. Although most active interventions showed sufficient therapeutic effect, this review highlights the need for further, high quality, adequately powered RCTs to evaluate the effects of these interventions which can ultimately provide reliable evidence to inform clinical decision making.

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e-pub ahead of print date: 7 October 2014
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 371964
URI: https://eprints.soton.ac.uk/id/eprint/371964
ISSN: 0007-0963
PURE UUID: aeb16fd4-6bc0-4f20-a543-b62429ab6287

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Date deposited: 26 Nov 2014 12:13
Last modified: 15 Jul 2019 21:38

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