Fungal nail infection: diagnosis and management

Eisman, Samantha; Sinclair, Rodney

doi:10.1136/bmj.g1800

Cited by 31 publications

(29 citation statements)

References 55 publications

(32 reference statements)

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“…The first‐line therapy for onychomycosis is oral antifungal agents . However, oral medications are reportedly associated with risks of impaired liver function and drug interactions . Moreover, many patients with onychomycosis are elderly and have concomitant diseases as well as diminished liver function, which may further increase the risks associated with these oral medications.…”

Section: Introductionmentioning

confidence: 99%

“…13,14 However, oral medications are reportedly associated with risks of impaired liver function and drug interactions. 15,16 Moreover, many patients with onychomycosis are elderly and have concomitant diseases as well as diminished liver function, 17,18 which may further increase the risks associated with these oral medications. Therefore, in order to avoid these risks, treatment with topical agents alone combined with debridement is often conducted, without administrating an oral medication.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy and safety of luliconazole 5% nail solution for the treatment of onychomycosis: A multicenter, double‐blind, randomized phase III study

Watanabe

Kuroda

Okubo

2017

The Journal of Dermatology

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Onychomycosis is a highly prevalent and intractable disease. The first-line treatment agents are oral preparations, but an effective topical medication has long been desired. The objective was to investigate the efficacy and safety of luliconazole 5% nail solution, an imidazole antifungal agent, for the treatment of patients with onychomycosis. A multicenter, double-blind, randomized phase III study was conducted in Japanese patients with distal lateral subungual onychomycosis affecting the great toenails, with 20-50% clinical involvement. Patients were randomized (2:1) to luliconazole or vehicle once daily for 48 weeks. The primary end-point was the complete cure rate (clinical cure [0% clinical involvement of the nail] plus mycological cure [negative results on direct microscopy]). The adverse event incidence was monitored to evaluate safety. The complete cure rate significantly favored luliconazole (14.9%, 29/194 subjects) versus vehicle (5.1%, 5/99) (P = 0.012). Similarly, the negative direct microscopy rate was significantly higher with luliconazole (45.4%, 79/174) than with vehicle (31.2%, 29/93) (P = 0.026). There were no serious adverse drug reactions. We conclude that once daily topical luliconazole 5% nail solution demonstrated clinical efficacy and was confirmed to be well tolerated.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of luliconazole 5% nail solution for the treatment of onychomycosis: A multicenter, double‐blind, randomized phase III study

Watanabe

Kuroda

Okubo

2017

The Journal of Dermatology

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“…Podem causar função tátil diminuída. Uma revisão recente de estudos de base populacional de onicomicose na Europa e nos Estados Unidos encontrou uma prevalência média de 4,3%, índice bem menor do que descrito neste estudo, no qual a prevalência encontrada foi de 59% dos casos 6 . O Brasil, por ser um país de clima tropical proporciona condições para instalação de infecções micóticas superficiais na pele, cabelos e unhas No Brasil, o diagnóstico micológico ainda é deficiente, principalmente entre os indivíduos com baixa renda e escolaridade, isso corrobora com condições precárias de habitação e ambiente 4,7,8 .…”

Section: Discussionunclassified

“…Podem ser classificados em antropofílicos, geofílicos e zoofílicos de acordo com seu habitat e podem se limitar aos sítios anatômicos onde a queratina está presente como pele, pelos e unhas. Dependendo da localização em que o dermatófito desenvolve a lesão, esta é denominada de tinea ou tinha, as quais são caracterizadas como tinea corporis, lesões na pele, tinea cruris localizada na região inguinal, tinea capitis a do couro cabeludo, tinea pedis nos pés, tinea mannum nas mãos, tinea barbae da barba do homem adulto e a tinea faciae na face da criança e mulher 6,7 . As leveduras também podem desenvolver micoses superficiais e cutâneas, principalmente o gênero Candida com manifestações clínicas semelhantes às lesões provocadas pelos dermatófitos, necessitando do diagnóstico micológico para confirmação 8 .…”

Section: Objectiveunclassified

Prevalence of Superficial and Cutaneous Mycoses in Patients Attending a University Extension Activity

Mezzari¹,

Hernandes²,

Fogaça³

et al. 2017

Rev. bras. ciênc. Saúde

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Objective:To verify the presence of superficial and cutaneous mycoses in the community and develop preventive actions to combat them, thereby providing better quality of life to the population. Methods: In view of the relatively high prevalence of fungal infections, we included in this study patients who had been referred to mycological diagnosis. They were verbally instructed with regard to mycosis concepts, forms of contamination, recurrences, among other subjects. The patients were given an explanatory manual including these guidelines. All procedures were performed by an academic student, who actively participated in all project execution stages, both in practical activities and in the development and implementation of preventive actions. Results: During the years 2013 and 2014, a total of 179 patients were treated and 199 clinical samples were collected from various anatomical sites. After mycological diagnosis, the patient was referred to the Primary Care Unit (PCU) to receive treatment. The most prevalent fungi were the yeasts Candida spp. (24.9%) and dermatophytes Trichophyton rubrum (24.9%), followed by Trichophyton mentagrophytes (22.4%). Conclusion: The results of the mycological diagnosis confirmed the presence of superficial and cutaneous mycoses in the sample. These findings reinforce the need to develop preventive actions that might reduce the prevalence of fungal infections.

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“…17 Even if no water analysis was made to confirm this, the nonfiltrated water of the pool could be suspected as a predisposing factor, especially in the warm months of summer, as T. rubrum growth is increased in hot water and filtration should be set up with UV disinfection. 2,4,15 Due to the very limited training, the old age of the animal, and the induced higher risks of anesthesia, the diagnostic opportunities were limited and did not allow blood collection from the animal. Therefore, the general health status could not be closely monitored, but the fact that no other sea lion in the group was affected suggests a possible failure in the functional activity of the diseased sea lion's self-defense mechanisms.…”

Section: Brief Communicationmentioning

confidence: 99%

A CASE OFTRYCHOPHYTON RUBRUMDERMATOPHYTOSIS IN A PATAGONIAN SEA LION (OTARIA BYRONIA)

Quintard¹,

Lohmann²,

Lefaux³

2015

Journal of Zoo and Wildlife Medicine

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Fungal nail infection: diagnosis and management

Cited by 31 publications

References 55 publications

Efficacy and safety of luliconazole 5% nail solution for the treatment of onychomycosis: A multicenter, double‐blind, randomized phase III study

Efficacy and safety of luliconazole 5% nail solution for the treatment of onychomycosis: A multicenter, double‐blind, randomized phase III study

Prevalence of Superficial and Cutaneous Mycoses in Patients Attending a University Extension Activity

A CASE OFTRYCHOPHYTON RUBRUMDERMATOPHYTOSIS IN A PATAGONIAN SEA LION (OTARIA BYRONIA)

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