Insights into the “fear factor” regarding terbinafine-associated hepatoxicity in an assessment of online information

Ishack, Stephanie; Miller, Rhiannon C.; Lipner, Shari R.

doi:10.1016/j.jaad.2022.02.006

Cited by 4 publications

(3 citation statements)

References 4 publications

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“…80 In a study evaluating 35 websites based on the accountability, quality, readability, display, support, and transparency of their terbinafine-related information, only 51.4% of websites had accurate information regarding terbinafine-related hepatotoxicity, and only 20.0% of websites mentioned that hepatotoxicity was rare. 82,83 Therefore, understanding misconceptions that patients may have regarding terbinafine and educating patients to make informed treatment decisions may combat these falsehoods.…”

Section: Dovepressmentioning

confidence: 99%

Antifungal Selection for the Treatment of Onychomycosis: Patient Considerations and Outcomes

Axler,

Lipner

2024

IDR

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Onychomycosis, a common fungal nail infection, affects >20% of adults over age 60 and >50% of people over age 70. Onychomycosis may cause pain, psychosocial problems, and secondary infections, therefore meriting treatment. This review describes the range of treatment modalities, including FDA-approved systemic drugs and topical therapies. Additionally, new and emerging oral and topical therapies are discussed. We emphasize the importance of tailoring onychomycosis therapy to individual patient characteristics, comorbidities, preferences, extent of nail involvement, and fungal species, such that physicians may optimize treatment outcomes, patient satisfaction, and safety.

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Section: Dovepressmentioning

confidence: 99%

Antifungal Selection for the Treatment of Onychomycosis: Patient Considerations and Outcomes

Axler,

Lipner

2024

IDR

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“…88 , 99 Although terbinafine-related hepatotoxicity is rare, patients are often hesitant to start terbinafine in fear of developing liver injury. 100 In an analysis of 35 websites with information on terbinafine, 100 only 51.4% provided accurate information on terbinafine-related hepatotoxicity and less than a quarter (20.0%) stated that hepatoxicity was rare. Few websites (11.4%) were authored by board-certified dermatologists.…”

Section: Oral Therapiesmentioning

confidence: 99%

Updated Perspectives on the Diagnosis and Management of Onychomycosis

Falotico¹,

Lipner²

2022

CCID

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Onychomycosis is the most common nail disease encountered in clinical practice and can cause pain, difficulty with ambulation, and psycho-social problems. A thorough history and physical examination, including dermoscopy, should be performed for each patient presenting with nail findings suggestive of onychomycosis. Several approaches are available for definitive diagnostic testing, including potassium hydroxide and microscopy, fungal culture, histopathology, polymerase chain reaction, or a combination of techniques. Confirmatory testing should be performed for each patient prior to initiating any antifungal therapies. There are several different therapeutic options available, including oral and topical medications as well as device-based treatments. Oral antifungals are generally recommended for moderate to severe onychomycosis and have higher cure rates, while topical antifungals are recommended for mild to moderate disease and have more favorable safety profiles. Oral terbinafine, itraconazole, and griseofulvin and topical ciclopirox 8% nail lacquer, efinaconazole 10% solution, and tavaborole 5% solution are approved by the Food and Drug Administration for treatment of onychomycosis in the United States and amorolfine 5% nail lacquer is approved in Europe. Laser treatment is approved in the United States for temporary increases in clear nail, but clinical results are suboptimal. Oral fluconazole is not approved in the United States for onychomycosis treatment, but is frequently used off-label with good efficacy. Several novel oral, topical, and over-the-counter therapies are currently under investigation. Physicians should consider the disease severity, infecting pathogen, medication safety, efficacy and cost, and patient age, comorbidities, medication history, and likelihood of compliance when determining management plans. Onychomycosis is a chronic disease with high recurrence rates and patients should be counseled on an appropriate plan to minimize recurrence risk following effective antifungal therapy.

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“…Effective alternative therapies for onychomycosis may be needed given poor medicaid coverage for onychomycosis treatment [91] and the patient "fear factor" regarding terbinafine-associated hepatoxicity [92]. There was moderate evidence for onychomycosis treatment with topical vitamin E, topical tazarotene, and oral acitretin in several clinical trials.…”

Section: Introductionmentioning

confidence: 99%

Vitamins for the Management of Nail Disease: A Literature Review

Curtis,

Lipner

2023

Skin Appendage Disord

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Background: Vitamins have gained popularity among physicians and patients for purported benefits to hair, skin, and nail health. Safe and efficacious therapies for nail disorders, many of which are chronic conditions, are needed. Summary: We conducted a literature review of studies assessing the efficacy of oral, topical, and intralesional vitamin/vitamin derivatives for the treatment of nail disorders, including yellow nail syndrome, brittle nail syndrome, onychomycosis, habit-tic nail deformity, periungual/subungual verruca, and nail psoriasis. Forty-nine articles were reviewed. There is good evidence to support the use of topical tazarotene and vitamin D analogs for nail psoriasis treatment. We found overall limited evidence for treatment of other nail disorders with vitamin/vitamin derivatives, and further research is needed to support their use. Key Messages: Besides topical tazarotene and vitamin D analogs for nail psoriasis treatment, there is limited evidence for treatment of nail disorders with topical, oral, and intralesional vitamin/vitamin derivatives.

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Insights into the “fear factor” regarding terbinafine-associated hepatoxicity in an assessment of online information

Cited by 4 publications

References 4 publications

Antifungal Selection for the Treatment of Onychomycosis: Patient Considerations and Outcomes

Antifungal Selection for the Treatment of Onychomycosis: Patient Considerations and Outcomes

Updated Perspectives on the Diagnosis and Management of Onychomycosis

Vitamins for the Management of Nail Disease: A Literature Review

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