Clinical Trial of Butylphenamide in the Treatment of Certain Varieties of Ringworm

THIS report concerns the topical use of butylphenamide* in the treatment of some of the common varieties of ringworm of the scalp and body. Laboratory data dealing with fungicidal effect "in vitro" and the absence of signs of toxicity in experimental animals suggested that butylphenamide would be a more valuable fungicide than any of the many others available. Our clinical impression is that this is so. Ideally all clinical trials should be carried out under strict statistical control, but from a purely practical point of view this is not possible when dealing with local applications which might be of value in the treatment of the various kinds of ringworm. This is so because the duration and response to treatment will vary with the type of fungus responsible and with the part of the body affected, and possibly with the type of skin which the patient has, ringworm being on the average rather more long lasting on a dark "hairy" skin than on a fair skin. The age of the patient may influence results, since we know that ringworm in babies clears relatively quickly. There is also good reason to believe that some fungi tend to lose virulence on transfer from one individual to another-and this will influence treatment results. Again, some patients will produce inflammatory and quickly clearing lesions, while others infected by the same fungus will react with chronic and indolent lesions. Finally, it is rare indeed to see ringworn lesions symetrically distributed on the body, so that using the method of paired comparisons is impractical. Therefore, no apology is offered for presenting what is little more than a series of clinical impressions regarding the usefulness or otherwise of butylphenamide tincture and ointment. However, the cases included in the trial were limited to those common infections which had been seen so often that one felt that a really beneficial response to treatment would be noticeable when the results of a series were compared with past results and colour photographs were taken of all cases at each attendance. Only those patients who attended as and when required until their ringworm was quite clear are included. Derivatives of salicylic acid and of salicylamides are known to possess fungistatic activity. Good results have been claimed from the use of preparations of sali-