Comparative Efficacy of Topical Oxiconazole Cream (1%) Versus Topical Clotrimazole Cream (1%) in the Treatment of Tinea Cruris

Abstract

ABSTRACT

OBJECTIVES

To compare the clinical efficacy of topical Oxiconazole 1% cream with topical clotrimazole 1% cream in patients with KOH-confirmed tinea cruris.

METHODOLOGY

The study was conducted in the Department of Dermatology, MTI-Hayatabad Medical Complex, Peshawar, from 12 May, 2025 to 12 Nov, 2025. A total of 386 patients aged 18–60 years with clinically diagnosed tinea cruris confirmed by potassium hydroxide mount were consecutively recruited and randomly allocated into two equal treatment groups. Group A received topical Clotrimazole 1% cream, while Group B received topical Oxiconazole 1% cream, applied twice daily for four weeks. Clinical severity was assessed at baseline and at Week 4 using a composite symptom score comprising pruritus, erythema, vesicles, and desquamation, each graded from 0 to 3. Clinical response was defined as ≥50% reduction in total symptom score at Week 4. The primary analysis was performed according to the randomized groups. Mean differences with 95% confidence intervals were calculated for symptom scores, and the risk difference with 95% confidence interval was calculated for clinical response. Data were analyzed using IBM SPSS version 25, with p≤0.05 considered statistically significant.

RESULTS
All 386 randomized patients were included in the Week-4 analysis, with 193 patients in each group. Baseline symptom scores were comparable between the groups. At Week 4, pruritus score was significantly lower in the oxiconazole group than in the clotrimazole group (0.74±0.63 vs. 0.93±0.58; mean difference -0.19, 95% CI -0.31 to -0.07; p=0.003). Week-4 erythema, vesicles, and desquamation scores did not differ significantly between the groups. Overall clinical response was achieved in 165/193 patients (85.5%) in the oxiconazole group and 157/193 patients (81.3%) in the clotrimazole group, with a risk difference of 4.1% (95% CI -3.3% to 11.6%; p=0.274). Clinical response remained comparable across gender strata.

CONCLUSION

Topical Oxiconazole 1% and Clotrimazole 1% creams showed comparable overall clinical response in KOH-confirmed tinea cruris after four weeks of treatment. Oxiconazole produced a statistically greater reduction in pruritus; however, the magnitude of difference was small. As Week-4 mycological cure, antifungal susceptibility, quality-of-life assessment, adverse-event profile, and recurrence after treatment were not assessed in the available dataset, the findings should be interpreted as short-term clinical response rather than confirmed microbiological eradication.