Background: Many clinicians prefer to treat onychomycosis systemically. However, systemic therapy may not be suitable for all onychomycosis patients due to drug interactions, side effects of oral medications, or comorbidities. 
Objective: Two topical agents (efinaconazole 10% in 2014 and luliconazole 5% in 2016) have recently been approved for treatment of onychomycosis in Japan. We investigated the efficacy of these topical agents at Teikyo University Mizonokuchi Hospital, Kanagawa, Japan. 
Method: We conducted a survey among patients diagnosed with onychomycosis at our outpatient clinic treated with either efinaconazole 10% solution or luliconazole 5% solution. Prior to commencement of treatment, the disease severity was evaluated using the Scoring Clinical Index for Onychomycosis (SCIO). Furthermore, the efficacies of these agents were evaluated using turbidity ratio at each visit to our outpatient clinic. 
Results: Fifty-five patients received efinaconazole 10% solution and 64 patients received luliconazole 5% solution. The median SCIO scores were 20 and 16, respectively. The ratios of patients showing slight to moderate clearance were 57% and 48% and mycological cure rates were 22% and 27% in the two groups, respectively.
Conclusion: The topical agents, efinaconazole 10% solution and luliconazole 5% solution were effective for onychomycosis and there were no significant differences in efficacy (Fisher’s LSD). These topical agents may become important tools for the treatment of onychomycosis.

Treatment outcome of efinaconazole 10% solution and luliconazole 5% solution for onychomycosis in Japan