Onychomycosis accounts for 50% of all nail disease cases and is commonly caused by dermatophytes. Diabetes, human immunodeficiency virus, immunosuppression, obesity, smoking, and advancing age are predisposing factors of this fungal infection. Potassium hydroxide and culture are considered the current standard for diagnosing onychomycosis, revealing both fungal viability and species identification. Other diagnostic tests currently available include periodic acid-Schiff staining, polymerase chain reaction techniques, and fluorescent staining. Across 6 recently published epidemiology studies, the global prevalence of onychomycosis was estimated to be 5.5%, falling within the range of previously reported estimates (2%-8%). Newly approved onychomycosis treatments include efinaconazole, tavaborole, and laser therapy with lasers only approved to temporarily increase the amount of clear nail. Additional onychomycosis treatments being investigated include iontophoresis and photodynamic therapy with small open-label studies reported thus far. Preventative strategies, to help decrease recurrence and reinfection rates, include sanitisation of footwear and prophylactic topical antifungal agents.

Current dosing regimens of reported drugs are effective and safe for use in tinea capitis in children.

9 Barley and yeast β-glucans were selected, together with lecithin, to encapsulate resveratrol by 10 emulsification-evaporation method to develop new and safer antifungal formulations. Different 11 emulsification techniques were used: high-shear, high pressure and high pressure and 12 temperature emulsification. Morphology, crystallinity, encapsulation efficiency and in vitro 13 antifungal activity against Botrytis cinerea of the different formulations were evaluated. No 14 significant differences between each emulsification procedure in particle size (below 90 nm) and 15 in encapsulation efficiency (70-100%) were observed; only barley β-glucan emulsions showed 16 lower efficiency due to the formation of a gel that retained most of the active compound. A 17 great influence of the emulsification method and the encapsulating material on the crystallinity 18 of the particles was observed. The highest antifungal activity (up to 53% growth inhibition) was 19 obtained by the formulations with yeast β-glucans, indicating an enhanced absorption of 20 encapsulated resveratrol through the cell wall of the fungus at the presence of (1-3, 1-6)-β-21 glucans. 22

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Onychomycosis is a fungal nail infection caused by dermatophytes, nondermatophyte molds, and yeasts. This difficult‐to‐treat chronic infection has a tendency to relapse despite treatment. This paper aims to offer a global perspective on onychomycosis management from expert physicians from around the world. Overall, the majority of experts surveyed used systemic, topical, and combination treatments approved in their countries and monitored patients based on the product insert or government recommendations. Although the basics of treating onychomycosis were similar between countries, slight differences in onychomycosis management between countries were found. These differences were mainly due to different approaches to adjunctive therapy, rating the severity of disease and use of prophylaxis treatment. A global perspective on the treatment of onychomycosis provides a framework of success for the committed clinician with appreciation of how onychomycosis is managed worldwide.