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James Q. Del Rosso, DO
Las Vegas Skin and Cancer Clinics Las Vegas, Nev

JAMA. 1997;278(14):1148.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—As a dermatologist, I would like to comment on a few of the statements made in the Contempo article on dermatology by Drs Dover and Arndt.¹

The first relates to the comment regarding "pulse terbinafine, 500 mg daily for 1 week a month for 3 months" for toenail onychomycosis. The referenced article² was a small study that was not statistically conclusive regarding efficacy. In addition, 4 pulses of terbinafine were administered, not 3 pulses as stated by Dover and Arndt. To address "pulsed terbinafine" treatment, it is important to clarify that adequate dosage duration finding studies and safety evaluations have not been published.

Second, Dover and Arndt state that "while fewer studies have been reported with fluconazole, 150 mg 1 day per week for up to 9 months produced cure rates of almost 90%," referring to treatment of toenail dermatophyte onychomycosis. The referenced article³ included 20 patients . . . [Full Text PDF of this Article]

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