Griseofulvin, a new orally administered antifungal
antibiotic which has proved to be effective for the treatment of a wide variety of superficial
fungus infections of man, was used in the treatment of 51 patients with
infections of the toenails due to T. rubrum. Thirty-four of the patients were treated with
griseofulvin alone and seven were treated with
griseofulvin combined with surgical avulsion of all involved toenails. The remaining ten had bilateral
infections, and avulsion was done on one foot but not the other before
griseofulvin therapy was begun. Of 34 patients who were treated with
griseofulvin alone, few had complete cure even after prolonged treatment. Some nails showed improvement for a time, then no further gain; some showed no improvement; some showed resistant wedges of
infection which penetrated proximally toward the posterior nail fold.In the instances of surgical avulsion, clinically normal nails regrew during
griseofulvin therapy. This simple procedure, with thorough removal of all underlying keratinous debris, apparently did away with foci of possible
reinfection. The results of the study indicated that surgical avulsion of the toenails in combination with
griseofulvin therapy is an effective and practical method of treating
onychomycosis of the toenails due to T. rubrum.