The Use of 40% Urea Cream in the Treatment of Moccasin Tinea Pedis

Moccasin tinea pedis is a chronic dermatophyte infection of the foot that is recalcitrant to topical antifungal therapy. Furthermore, most patients with moccasin tinea pedis also have onychomycosis, thus adding to the recalcitrant nature of the infection. The topical antifungals used as sole therapy are generally ineffective because the scale on the plantar surface impedes or limits the absorption of the antifungal agent. The aim of this study was to evaluate the efficacy of 40% urea cream as an adjunct to topical antifungals in the treatment of moccasin tinea pedis. Patients with untreated moccasin tinea pedis were selected from the general dermatology clinic. The diagnosis of moccasin tinea pedis was made clinically and confirmed with a potassium hydroxide test or a positive fungal culture. A total of 12 patients with moccasin tinea pedis were treated with 40% urea cream once daily and ciclopirox cream twice daily. Patients then were evaluated after 2 to 3 weeks of treatment for the presence of erythema, scaling, and pruritus. After 2 to 3 weeks, a 100% cure rate was achieved in the 12 patients treated with topical 40% urea cream and ciclopirox cream concomitantly.