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Penlac for Diabetic Patients with Toenail Fungus

Researchers at the Institute for Diabetic Foot Research in New York, studied 49 type II diabetics with distal subungual onychomycosis (DSO – the most common type of toenail fungus). The patients were treated with ciclopirox 8% topical laquer (Penlac®) once daily for 48 weeks.

Results: At the end of the study 63% of the patients achieved clinical improvement, 86% of patients had mycologic improvement and 54% attained a mycologic cure. No serious adverse advents were observed during the trial period.

Summary: This study concludes that Penlac® is a safe and effective treatment for diabetics with mild to moderate toenail fungus.

Brenner MA, Harkless LB, Mendicino RW, Page JC. Ciclopirox 8% nail lacquer topical solution for the treatment of onychomycosis in patients with diabetes: a multicenter, open-label study. J Am Podiatr Med Assoc. 2007 May-Jun;97(3):195-202.


  • Distal subungual onychomycosis, as seen in the picture above, is the most common type of toenail fungus and is generally a mild to moderate type of toenail fungus.
  • Ciclopirox 8% laquer is the generic name for the prescription medication Penlac®. Ciclopirox is applied like a nail polish.
  • Toenail fungus in a diabetic is a risk factor for ingrown toenails, ulcerations and bacterial infections. Having an effective topical medication for use in treatment is significant.
  • It is important to note that the patients in this study were treated for 48 weeks.
  • Mycologic cure means that there was a negative culture or negative microscopy. These tests are not entirely accurate, therefore not definitive, which is why they are used in conjunction with clinical cure.
  • Clinical cure means that there is no evidence of the fungal disease, whereas clinical improvement is variable and subjective. In this study, they evaluated the nail surface, color and thickness to help define clinical improvement.
  • This study does not tell us about the effectiveness of ciclopirox in the general population (previous studies of ciclopirox in the general population have not shown the same effectiveness).
  • This study also does not tell us the effectiveness of ciclopirox in severe cases of onychomycosis with associated dystrophic changes, as seen in the picture here.

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