***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Clotrimazole is a new antifungal agent which is effective topically in dermatophytosis , cutaneous c and idiasis , and tinea vesicolor . The authors performed a controlled double-blind clinical trial comparing topical clotrimazole with its vehicle in the treatment of 66 patients with dermatophytic infections of the skin of the feet .  Clotrimazole proved to be effective in the treatment of tinea pedis of both the interdigital and the plantar hyperkeratotic types Twenty-three patients were enrolled in a r and omized , double-blind trial of terbinafine 1 % cream compared with placebo vehicle in the treatment of tinea pedis . Of the 20 patients who were evaluated for efficacy , 10 received terbinafine and 10 received placebo . Except for the  terbinafine-treated patients being an average of 11 years older than the patients receiving placebo  and the median duration of disease being 6 weeks longer in the placebo group , the two groups were demographically and clinical ly similar . Results of mycologic tests and clinical findings showed terbinafine to be significantly more effective than placebo in the treatment of tinea pedis . Significantly more terbinafine-treated patients than placebo-treated patients showed conversion to negative culture and microscopy at end of therapy and a significant reduction in scored signs and symptoms . Overall efficacy at follow-up ( combined mycologic and clinical findings ) was also significantly greater in the terbinafine group ( 78 % ) than in the placebo group ( zero ) ( p less than 0.001 ) . Unexplained elevation of liver function test results was noted in three placebo-treated patients and in one terbinafine-treated patient , but these changes were not considered clinical ly relevant or drug related Thirty men with clinical and mycologic evidence of tinea cruris were enrolled in a controlled , r and omized , double-blind trial comparing terbinafine 1 % cream and its cream vehicle as placebo . Patients applied the test medications to the affected area twice daily for 2 weeks . Therapeutic response was evaluable in 18 patients after each week of treatment and at a follow-up visit 2 weeks after therapy ended . At each visit , terbinafine was found to be more effective than the cream vehicle in the reduction of the signs and symptoms of infection and in the conversion of culture and microscopy findings to negative or normal . At the end of treatment , therapy was effective in 67 % of the nine terbinafine-treated patients compared with only 11 % of the nine placebo-treated patients . At the follow-up examination , efficacy rates were 78 % in the terbinafine treatment group and 33 % in the placebo group -- a difference of borderline statistical significance ( p = 0.077 ) . Possible reasons for this result may include the higher incidence of chronic disease in the terbinafine group and the large number of patients who were classified as delayed exclusions because of negative initial culture for dermatophytes . No side effects or significant alterations in laboratory or hematologic tests were observed in either treatment group 1 . Steere AC , Malawista SE , Bartcnhagen NR , et al. The clinical spectrum and treatment of Lyme disease . Yale J Bioi Med 1984;57:453 - 61 . 2 . Berger BW . Erythema chronicum migrans of Lyme disease . Arch DermatoI1984;120:1017 - 21 . 3 . Kramer N , Rickert RR , Brodkin RH , et al. Septal panniculitis as a manifestation of Lyme disease . Am J Med 1986 ; 81:149 - 52 . 4 . Eichenfield AR , Goldsmith DP , Benach JL , et al. Childhood Lyme arthritis : experience in endemic area . J Pediatr 1986;109:753 - 8 . 5 . Russell H , Sampson JS , Schmid GP , et al. Enzyme-linked immunosorbent assay and indirect immunofluorescence assay for Lyme disease . ] Infect Dis 1984;149:465 - 70 . 6 . Duffy J , Mertz LE , Wobig GH , et al. Diagnosing Lyme disease : the contribution of serologic testing . Mayo Clin Proc 1988;63 : 1116 - 21 . 7 . Gammon WR . Urticarial vasculitis . Dermatol Clin 1985 ; 3:97 - 105 . 8 . Monroe EW , Schulz CI , Maize JC , et al.  Vasculitis in chronic urticaria : an immunopathologic study . J Invest DcrmatoI1981;76:103 - 7 . 9 . Midgard R , Hofstad R. Unusual manifestations of nervous system Borrelia burgdorferi infection . Arch Neurol J987 ; 44:781 - 3 . 10 . Camponovo F , Meier C. Neuropathy of vasculitic origin in a case of Garin-Boujadoux-Bannwarth syndrome with positive Borrelia antibody response . J Ncurol 1986;233 : 69 - 72 Malassezia furfur ( Pityrosporum orbiculare ) was confirmed by microscopic potassium hydroxide ( KOH ) examination in 101 patients with recurring lesions of tinea versicolor . In a double-blind comparative study , patients were r and omly assigned to once-daily ketoconazole 2 % or placebo cream . At the end of treatment , 98 % ( p less than 0.0001 ) of the patients using ketoconazole and 28 % of those using placebo  responded clinical ly ( healed or had mild residual disease ) . There was an overall 84 % mycologic cure rate ( negative KOH at treatment end ) for patients using ketoconazole 2 % cream and 10 % for those using placebo cream ( p less than 0.0001 ) . Ketoconazole-treated patients who were cured at the end of treatment remained cured 8 weeks later . By contrast 75 % of those responding to placebo had relapsed by the 8-week follow-up visit . Follow-up after 2 years revealed that 79 % ( 38/48 ) of the patients treated with ketoconazole remained clear 12 or more months Twenty-seven patients with chronic tinea pedis , athlete 's foot type , were enrolled in a r and omized , double-blind trial of topical treatment with terbinafine 1 % cream versus its vehicle ( placebo ) . Patients were examined weekly during 4 weeks of twice-daily treatment and at follow-up 2 weeks after the conclusion of therapy . No adverse events were reported in either treatment group . Drug efficacy was evaluated in 22 patients , of whom nine ( 41 % ) were treated with terbinafine and 13 ( 59 % ) with placebo . Analysis of combined mycologic and clinical results showed that terbinafine was significantly more effective than placebo at the end of therapy ( 78 % vs zero ) and at the 2-week follow-up ( 89 % vs zero ) ( p less than or equal to 0.001 at both intervals BACKGROUND Patients with tinea pedis often discontinue treatment before eradication of the fungus when their symptoms improve . The result is an incomplete cure/recurrence . OBJECTIVE Terbinafine , a topical fungicidal agent , was evaluated in double-blind , placebo-controlled trials ( 159 patients ) for its ability to achieve cure and relief of symptoms in the same time frame , that is , before compliance wanes . METHODS Mycologic characteristics ( with potassium hydroxide examination and culture ) and clinical signs and symptoms were assessed at baseline , at the end of a 1-week , twice-daily treatment and at 1 , 3 , and 5 weeks after the completion of therapy . RESULTS Both terbinafine and vehicle provided early relief of symptoms . However , only terbinafine gave progressive mycologic improvement such that at 5 weeks after treatment , 88 % of the patients receiving terbinafine had converted from positive to negative mycology compared with 23 % of the patients treated with vehicle . CONCLUSION The rapid and potent fungicidal action of terbinafine results in a high cure rate in interdigital tinea pedis with 1 week of treatment and may avoid failures caused by non-compliance Data from 104 subjects with tinea cruris or tinea corporis were evaluated in this double-blind , r and omized study . The subjects applied naftifine cream 1 % or econazole nitrate cream 1 % to affected areas twice daily for 4 weeks . After 1 week of treatment naftifine had an overall cure rate of 19 % compared with 4 % for econazole ( p = 0.03 ) . A difference in favor of naftifine , although not statistically significant after the first week , persisted throughout treatment . Two weeks after the end of treatment both medications had overall cure rates of approximately 80 % . Three percent of the naftifine-treated subjects had side effects compared with 13 % of the econazole-treated subjects . In two subjects using econazole , the side effects were severe enough to warrant discontinuation of treatment Twenty-three patients were enrolled in a r and omized , double-blind trial of terbinafine 1 % cream versus its vehicle ( placebo ) in the treatment of tinea cruris . One patient had a negative initial culture and was excluded , and two patients were dropouts , one because of poor study compliance  ( terbinafine ) and one because of an adverse event  ( placebo ) . Twenty patients were examined for efficacy of treatment ( 9 terbinafine-treated , 11 placebo-treated ) . Both groups were similar in age , sex , duration of disease , prior therapy , size and location of lesion , infecting organism , and predisposing factors . Terbinafine 1 % cream was more effective than vehicle cream in the reduction of the signs and symptoms of tinea cruris . In addition , there was a higher conversion rate to negative culture and normal microscopy findings in the terbinafine-treated group . Clinical results combined with evaluation of mycologic tests at end of therapy showed terbinafine to be a rapid and significantly more effective treatment for tinea cruris than placebo ( 78 % vs 18 % cure rate , respectively ) . Follow-up cure rates confirmed these findings ( 89 % and 18 % , respectively ) . No significant adverse events occurred during terbinafine treatment To determine the safety and efficacy of topical sertaconazole nitrate cream 2 % in the treatment of tinea pedis , 2 r and omized , multicenter , double-blinded , parallel group , vehicle-controlled studies were conducted . A total of 588 subjects were enrolled , and 383 subjects were r and omized to treatment with sertaconazole or vehicle  applied twice daily for 4 weeks . Improvements in symptoms were noted at week 1 in the active treatment group . At week 4 , mycologic cure was seen in 70.3 % of sertaconazole-treated subjects and 36.7 % of vehicle-treated subjects ( P<.0001 ) . At week 6 , 46.7 % of sertaconazole-treated subjects had successful treatment outcomes compared with 14.9 % of vehicle-treated subjects ( P<.0001 ) . No serious adverse events were reported , and rates of cutaneous adverse events were comparable between treatment groups . In conclusion , sertaconazole nitrate cream 2 % was well-tolerated , offered rapid relief of symptoms , and achieved high rates of mycologic cure . The stability of the mycologic cure rates through weeks 5 and 6 ( 2 weeks after cessation of therapy ) indicate that sertaconazole protects against reinfection The antifungal efficacy and tolerability of 1 % terbinafine cream vs. 1 % bifonazole cream were assessed in a single blind r and omized trial in patients with pityriasis versicolor .  Terbinafine , a drug of the allylamines group , a new class of anti-mycotic agents , blocks sterol bio synthesis in the pathogen through inhibition of squalene epoxidase and consequent squalene accumulation , a primarily fungicidal process . Forty pityriasis versicolor patients , ( 18 M , 22 F ; mean age 32.4 years ; min . 16 , max . 65 ) , used 1 % terbinafine cream or 1 % bifonazole cream for a maximum of 4 weeks . All patients were followed-up weekly both clinical ly and mycologically . Clinical cures , defined as negativization of each clinical parameter , were recorded for 20 terbinafine patients ( 100 % ) and 19 bifonazole patients ( 95 % ) , with routine microscopy and Wood 's light tests both negative . By the 2nd week of treatment , 2 terbinafine patients were mycologically cured ( 10 % ) . By the 3rd week , 14 terbinafine patients ( 70 % ) and 5 bifonazole patients ( 25 % ) were mycologically cured . The present controlled clinical trial consequently demonstrates that terbinafine is rapidly effective and well tolerated for treatment of pityriasis versicolor Bifonazole 1 % cream ( Mycospor 1 ) was compared to its cream vehicle in the treatment of tinea versicolor , using a once-a-day application for 2 weeks . Patients were evaluated both clinical ly and mycologically in order to assess the efficacy and tolerance of the medication . 29 patients were evaluated by statistical analysis .  Bifonazole cream 1 % was shown to be significantly more effective in 
    Output:
    
There is consistent evidence of the superiority of antifungal drugs over the use of placebo , and placebo-controlled studies are no longer justifiable .
Allylamines maintain the mycological cure for longer periods compared to azole drugs .