Superficial cutaneous
fungal infections (SCFIs) are commonly encountered in clinical practice in the United States, and comprise
infections of the skin by dermatophytes and yeasts. The most common organisms causing SCFI are dermatophytes, especially Trichophyton spp. With the exception of onchomycosis and
tinea capitis, most cases of SCFIs are amenable to properly selected topical antifungal
therapy used over an adequate period of time.<br><br> A variety of topical
antifungal agents are available for the treatment of SCFIs, and they encompass a few major chemical classes: the
polyenes (ie,
nystatin),
imidazoles (ie,
ketoconazole,
econazole,
oxiconazole, etc), allylamines (ie,
naftifine,
terbinafine),
benzylamines (ie,
butenafine), and hydroxypyridones (ie,
ciclopirox). The 2 major classes that represent the majority of available topical
antifungal agents are the
azoles and the allylamines. Overall, the allylamines are superior to the
azoles in activity against dermatophytes, although both are clinically effective. The reverse is true against yeasts such as Candida spp and Malassezia spp, although topical allylamines have proven to be efficacious in some cases of
tinea versicolor and
cutaneous candidiasis.<br><br>
Naftifine, a topical
allylamine, is fungicidal in vitro against a wide spectrum of dermatophyte fungi and has been shown to be highly effective against a variety of cutaneous dermatophyte
infections. Rapid onset of clinical activity and favorable data on sustained clearance of
infection have been documented with
naftifine. The more recent addition of
naftifine 2% cream has expanded the armamentarium, with data supporting a clinically relevant therapeutic reservoir effect after completion of
therapy.