A Savannah Man
Gets to the Bottom
Of a Nasty Affliction
Mr. Thomas's Book Declares
War on Toenail Fungus;
Solution Shows Promise
By BARRY NEWMAN
Staff Reporter of THE WALL STREET JOURNAL
November 21, 2005; Page A1

SAVANNAH, Ga. -- Bookstores assign yards of shelving to tales of
triumph over alcoholism and diabetes, obesity and stroke. Dwight
Thomas has written a tale of triumph about his toenails.

"Leukemia had a best seller," said Mr. Thomas, author of "The War
Against Toenail Fungus." In breathable sneakers, he stood one day at
the writing table in a front room of his townhouse here. "Toenail
fungus is ignored," he said. "It's extremely widespread. Nobody knows
much about it, and you can't get rid of it. I leaped into the breach.
This is a toenail-fungus patient memoir."

Toenail fungi, the same bugs that cause athlete's foot, squeeze under
toenails and hide. They turn toenails yellow and crumbly. For reasons
not well understood, they dig in deeper as people age. Now they're
besieging the veterans of the fitness fad. Toenail fungus, in Mr.
Thomas's words, is a "disgustingly earthy problem."
[Dwight Thomas]

And one ripe for pharmacological exploitation. In America, according
to Kalorama Information, a market-research publisher, 35 million
people have it, and they spend around $1 billion a year trying to kill it.

Drugstores are full of toenail-fungus nostrums -- Mycocide, Miracle
Anti-Fungal, Dr. Blaine's Tineacide. Many of the packages have toenail
photos and fine print acknowledging the view of the Food and Drug
Administration that toenail-protected fungi are beyond their reach.
The Internet crawls with unsure cures: neem oil, emu oil, aloe sludge,
vinegar baths, bleach, Vicks VapoRub.

"I have that ugly fungus on my big toenail," says a chat-room posting.
"Thick, brown etc. I was told if I soak it in urine that it should be
gone in a week. Any info as to whether this is valid?"

Not really. Only a few new and costly prescription drugs -- Lamisil
and Penlac are two big ones -- have proven ability to penetrate a
toenail. Mr. Thomas first learned of them six years ago on a visit to
his dermatologist. It was on "a dull, dark, fateful day in January
1999," he writes, that the doctor "peered at my naked toes," looked up
and said, "It's the fungus."

Fine-featured and 60 years old, Mr. Thomas belongs to one of
Savannah's well-off founding families. He lives just across Monterey
Square from the mansion where John Berendt set "Midnight in the Garden
of Good and Evil." He never attended the fancy parties thrown there.
As a note on his doorbell explains, Mr. Thomas, who has a doctorate in
literature, sleeps twice a day -- at dawn and dusk -- and writes at
his computer in the afternoons and in the wee hours.

His 1987 work, "The Poe Log," is a 919-page account of what Edgar
Allan Poe did on every day of his life. He calls it "an act of
fanaticism." Twelve years after his Poe book, Mr. Thomas began to get
the itch to do a toe book.

Shuttling from his dermatologist to his podiatrist, he tried Lamisil.
It worked; then the fungus came back. He tried Penlac. It worked; then
the fungus came back. Months passed. One tiny vial of Penlac cost him
$200. A Lamisil tablet -- one a day for 12 weeks -- cost over $8.
Those cartoon bugs in Lamisil's ads got very annoying. And under the
big toe of his left foot, the fungus stayed put.

Fed up, he took his toenails into his own hands. Tirelessly, he read
the full corpus of fungal literature. Careful to avoid the potential
side effect of liver damage, he devised a new regimen for himself,
using Lamisil and Penlac at the same time. It worked: The fungus left
and stayed gone. It was then, in empathy with millions of sufferers
and co-dependents, that Mr. Thomas realized his journey of toenail
discovery deserved a memoir.

He struck a military theme, aiming at the ungually fungal Vietnam
generation, and two years ago turned out a 221-page volume replete
with scientific citations. Sensing that big publishers wouldn't buy
it, Mr. Thomas published the book himself, illustrated with his own
battle-map drawings of his right big toe.

Soon, it hit home that marketing a fungus memoir could be harder than
writing one, particularly for "somebody who's sort of removed." The
toenail category had competitors: a slew of Web sites, one selling a
downloadable book. There was only one print challenger, Mike Tecton's
"How I Cured Deadly Toenail Fungus."

Mr. Tecton has written 89 other books, including "Tudor Wood
Paneling," "Communist Causes of the Civil War," and "Enchanting
Storybook Homes." Reached at home in McLean, Va., Mr. Tecton, 76,
qualified his claim to have cured toenail fungus. "I actually got it
back," he said. "I still have it."

In a wide-open field, Mr. Thomas might have promoted his book in Dr.
Leonard's, the discount health catalog, alongside the bunion shields
and toe separators. Instead, he ran a string of ads in the New Yorker
magazine. Later, he switched to the Atlantic Monthly.

Mr. Thomas decided against a nail-salon book tour, perhaps wisely. At
Sassy Nails in downtown Savannah, June Dang was shown a copy of his
toenail book while she was manicuring Tammy Woods's fingernails one
morning.

"Would you read a whole book on toe fungus?" asked Ms. Dang.

"Probably not," Ms. Woods replied. "I'd only purchase it if it had
other-parts-of-the-body funguses as well."

Esther Shaver stocks local authors at her bookstore two blocks from
Monterey Square. Mr. Thomas never gave her "The War Against Toenail
Fungus." He hasn't shown the book to the local podiatrists and
dermatologists he consulted. He hasn't sent it to Sanofi-Aventis SA,
Penlac's maker, or Novartis AG, the maker of Lamisil. But Mr. Thomas
feels he's done all he could to market a book on toenail fungus. And,
it turns out, his double-drug solution might be right.

Without seeing it, no one at Sanofi-Aventis or Novartis could comment
on the book. But Sanofi has independently come to the same idea. It
has funded a large-scale clinical trial going far beyond Mr. Thomas's
toes. Its lead researcher, dermatologist Abitya Gupta, expects results
by 2007. He says the early data suggest that Lamisil and Penlac in
concert are "indeed more effective than either drug alone."

Sales of "The War Against Toenail Fungus" have broken into the low
thousands. Mr. Thomas has a new ad running in Harper's. Still, he has
faced the fact that toenails don't make literary careers. His third
book, almost done, is a history of research on breast cancer.

"What really sells a patient memoir is word of mouth," he said, seated
among file boxes and athlete's-foot remedies in his writing room. "But
this disease is not discussed at cocktail parties. Nobody discusses it
at all." Mr. Thomas added: "Toenail fungus has no word-of-mouth
potential."

Corrections & Amplifications:

An earlier version of this article misspelled Edgar Allan Poe's name.