Management of Athlete's foot with topical Zinc Sulphate (15%) Solution versus Clotrimazole (1%) Solution

Abstract

Background: Athlete's foot (tinea pedis) is by far the commonest fungal infections of the integument in the developed world that usually begins between the toes. Multiple drugs were used for the treatment of athlete's foot and including both; topical and systemic agents.Zinc sulphate has been used as topical antifungal agent. Objective: Comparison the efficacy of 15% zinc sulphate solution topically in the management of tinea pedis with topical clotrimazole solution. Patients and Methods: A therapeutic, single blind, comparative, study of Zinc Sulphate solution (15%) in the management of tinea pedis in comparison with clotrimazole solution (both topically), that conducted in the Unit of Dermatology and Venereology ,Baquba Teaching Hospital, extended from March 2020- July 2021 . Fifty patients, 31 males and 19 females with tinea pedis were registered in this study. Divided to 2 groups of patients included in the study: Group A: Use the topical zinc sulphate solution 15%. Group B: Use the topical 1% Clotrimazole solution. A complete history with examination clinically were done for all patients with tinea pedis involving all the relevant points. All patients were used the medicine twice daily for 30 days, and follow there to be seen every 14 days during the course of treatment and then follow up for two months. The patients were examined clinically; also the scoring of feet odor was done at each visit. Results: Group A: Twenty five patients 9 (36%) females and 16 (64%) males were included in this group were treated by Zinc Sulphate solution , and their ages ranged between 27-73(47.8±12.18) years. and the duration of that illness was ranged from 1-120(43±46.61) months. Clinical response after one month of the treatment was 10(40%) patients with complete clearance, 5(20%) patients had partial clearance while 10(40%) patients showed no response. Group B: Twenty five patients treated by clotrimazole solution, and their ages ranged from 24-65(43.2±11.83) years, and the duration of the illness was ranged from 1-180(30.24±44.9) months. Clinical response after four weeks of treatment was 19(76%) patients with complete response, 2(8%) patients had partial response, while 4(16%) patients have no response. There was no statistical significance difference at two weeks in comparison between group A and B (chi square 5.37 P value =0.07) but was slightly significant at four weeks (chi square 6.65, P value =0.04). Side effects of treatment were mild which included itching and burning sensation in 4(16%) patients of group A and in 1(4%) patients of group B. These side effects did not require discontinuation of the treatment. Conclusion: Clotrimazole solution was superior to15% Zinc sulphate solution as effective as topical treatment for Athlete's foot. Keywords: Tinea pedis, topical zinc sulphate, clotrimazole