Cases Journal


Open Access Case Report

Preventing long term relapsing tinea unguium with topical anti-fungal cream: a case report

Bruce Arroll1* and Amanda Oakley2

Author Affiliations

1 University of Auckland, Private Bag 92019, Auckland, New Zealand

2 Department of Dermatology, Waikato Hospital, Private Bag 3200, Hamilton 3001, New Zealand

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Cases Journal 2009, 2:70 doi:10.1186/1757-1626-2-70

Published: 21 January 2009

Abstract

Background

The patient was aged 34 when he consulted a dermatologist in Vancouver BC with onychomycosis affecting the right great toenail.

Case presentation

Trichophyton rubrum was cultured from nail clippings. Griseofulvin was taken for 6 months, resulting in clinical and mycological cure. Over the next 27 years there were multiple relapses. Each course of treatment with oral terbinafine (for up to 18 months) or itraconazole resulted in clinical and mycological cure. A dermatological colleague suggested the reason for relapse was likely to be self re-infection.

Conclusion

No clinical relapse has occurred with once-weekly miconazole cream applied to the toenail and webspaces of the right foot over the last four years.