Transungual delivery: deliberations and creeds

Abstract

SynopsisAlthough considered as trifling illness, nail diseases have a reasonably high occurrence and a noteworthy impact on the patients' quality of life. Furthermore, there is a need to improve the topical treatment for nail diseases to avoid drug interactions and to reduce side effects associated with oral therapy. Topical drug delivery to the nails has established amplified consideration lately. Strategies (such as chemical enhancers, formulation strategies, physical and mechanical methods) are being investigated in order to improve drug permeability across the nail plate. The rationale of this review is to present contemporary information on the structure of human nail along with its comparison with animal hooves. Precincts of nail permeability have been briefly discussed with respect to factors like permeant's molecular size, hydrophilicity, charge and the nature of the vehicle. These factors affect drug uptake and permeation through the nail. Formulations like nail lacquers which mimic cosmetic varnish and colloidal carriers along with nail substitutes that can be utilized for transungual delivery have also been discussed. R esum eBien que consid er e comme etant une maladie insignifiante, les affection des ongles sont relativement fr equentes et ont un impact notable sur la qualit e de vie des patients. En outre, il s'av ere n ecessaire d'am eliorer le traitement topique des maladies des ongles pour eviter les interactions m edicamenteuses et de r eduire les effets secondaires associ es a une th erapie orale. L'administration de m edicaments topiques pour les ongles a rec ßu une consid eration amplifi ee ces derniers temps. Diverses strat egies (activateurs chimiques, des strat egies de formulation, des m ethodes physiques et m ecaniques) sont a l' etude afin d'am eliorer la perm eabilit e de la drogue a travers la plaque de l'ongle. La justification de cette revue est de pr esenter des informations contemporaines sur la structure de l'ongle humain, en la comparant avec les sabots des animaux. Les pr eceptes de perm eabilit e des ongles vontêtre bri evement discut es par rapport a des facteurs comme la taille mol eculaire du perm eant, l'hydrophilie, la charge et la nature du v ehicule, etc. Ces facteurs affectent l'absorption du m edicament et la perm eation a travers l'ongle. Des formulations comme les vernis a ongles qui imitent les vernis cosm etiques et des vecteurs collo€ ıdaux ainsi que les substituts des ongles qui peuventêtre utilis es pour la livraison TU (transungueale) sont egalement examin es.

Ciclopirox Hydroxypropyl Chitosan (HPCH) Nail Lacquer: A Review of Its Use in Onychomycosis

“…Topical antifungals are associated with a low risk of systemic AEs and drug interactions [ 6 ]; however, the hard keratin and compact nail plate structure of the dorsal nail plate act as a barrier to effective drug delivery via traditional topical formulations, such as creams and ointments [ 7 , 8 ]. This has led to the development of nail lacquers, a formulation which improves penetration of the drug through the nail plate [ 9 ] while maintaining a proper drug concentration at the nail surface [ 8 ]. However, the first medicated nail lacquers contained water-insoluble monoester film-forming agents that have no affinity to keratin and act as occlusive medications, thereby reducing the diffusion of antifungal drugs from subsequent applications through the nail and limiting efficacy [ 10 ].…”

Fungal infection models: Current progress ofex vivomethods

“…The concentration of minerals such as calcium, magnesium, sodium and copper is the main difference observed, but the amino acid content reveals a similar profile. A limitation that deserves attention when using animal hooves refers to hydration, which during the experiments causes greater water absorption, being able to lead to an overestimation of the permeability of the drug in relation to the human nail …”

Is This the Right Drug or the Dose for the Management of Onychomycosis?

“…*Not Mentioned invasiveness, localized effects and obliteration of systemic adverse events and drug interactions [40]. The primary drawback associated with the existing topical antifungal agent is their inability to penetrate into the nail plate resulting in poor mycological and complete cure rates.…”