Systematic Review
Evidence-based topical treatments for tinea cruris and tinea corporis: a summary of a Cochrane systematic review
E.J. van Zuuren,
Z. Fedorowicz,
M. El-Gohary,
Corresponding Author
E.J. van Zuuren
Department of Dermatology, B1-Q, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, The Netherlands
Correspondence
Esther J. van Zuuren.
E-mail [email protected]
Search for more papers by this authorZ. Fedorowicz
Bahrain Branch, The Cochrane Collaboration, Awali, Bahrain
Search for more papers by this authorM. El-Gohary
Primary Care and Population Sciences, Faculty of Medicine, Aldermoor Health Centre, University of Southampton, Southampton, U.K
Search for more papers by this authorE.J. van Zuuren,
Z. Fedorowicz,
M. El-Gohary,
Corresponding Author
E.J. van Zuuren
Department of Dermatology, B1-Q, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, The Netherlands
Correspondence
Esther J. van Zuuren.
E-mail [email protected]
Search for more papers by this authorZ. Fedorowicz
Bahrain Branch, The Cochrane Collaboration, Awali, Bahrain
Search for more papers by this authorM. El-Gohary
Primary Care and Population Sciences, Faculty of Medicine, Aldermoor Health Centre, University of Southampton, Southampton, U.K
Search for more papers by this authorFunding sources None.
Conflicts of interest None declared.
This paper is based on a Cochrane review published in Issue 8, August 2014 of The Cochrane Library (seehttp://www.CochraneLibrary.net for further information).
Cochrane reviews are regularly updated as new evidence emerges and in response to comments and criticisms. The Cochrane Library should be consulted for the most recent version of this review.
Summary
Tinea cruris and tinea corporis are common fungal infections. Most 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 the Cochrane Skin Group Specialised Register, CENTRAL in The Cochrane Library, Medline, Embase, LILACS and ongoing trials registries (August 2013). One hundred and twenty-nine randomized 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. In five studies, terbinafine showed a statistically significant higher clinical cure rate compared with placebo [risk ratio (RR) 4·51, 95% confidence interval (CI) 3·10–6·56]. Data for mycological cure could not be pooled owing to substantial heterogeneity. Across three studies, mycological cure rates favoured naftifine (1%) compared with placebo (RR 2·38, 95% CI 1·80–3·14) but the quality of the evidence was 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. Sixty-five studies were assessed as ‘unclear’ and 64 as being 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.
Supporting Information
| Filename | Description |
|---|---|
| bjd13441-sup-0001-Fig1.jpgJPEG image, 2.7 MB | Fig S1. Studies was assessed for risk of bias. ⊕, low risk of bias; ⊖, high risk of bias; (?), unclear risk of bias. |
| bjd13441-sup-0002-Table1.docxWord document, 22.5 KB | Table S1. Included studies with unusable or irretrievable data. |
| bjd13441-sup-0003-Table2.docxWord document, 20.1 KB | Table S2. Summary of findings of azoles compared with allylamines. |
| bjd13441-sup-0004-Table3.docxWord document, 20.6 KB | Table S3. Summary of findings of azoles compared with azoles/moderately potent corticosteroid combinations. |
| bjd13441-sup-0005-Table4.docxWord document, 18.7 KB | Table S4. Summary of findings of azoles compared with benzylamines. |
| bjd13441-sup-0006-Table5.docxWord document, 18.2 KB | Table S5. Summary of findings of azoles compared with placebo. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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