Topical Luliconazole Treatment for Hyperkeratotic Tinea Pedis

Chronic hyperkeratotic (moccasin-type) tinea pedis is a treatment-resistant infection. We evaluated the efficacy of a 3-month course of topical 1% luliconazole in 21 hyperkeratotic tinea pedis patients. The diagnosis was confirmed through microscopy and culture. The lesion area was assessed monthly using a software program. Clinical responses were classified into five categories from “cured” to “no change.” A terbinafine-resistant Trichophyton rubrum isolate was identified. The mean lesion area decreased significantly over 3 months, with an average improvement rate of 94.1% ± 12.7% and a cure rate of 61.9%. The mean amount of luliconazole used per foot was 27.5 ± 9.7 g monthly. The resistant case showed a partial improvement with topical luliconazole and was successfully treated with oral fosravuconazole. These findings suggest that 1% topical luliconazole is effective for treating hyperkeratotic tinea pedis, including cases caused by terbinafine-resistant strains.