Peculiarities of Treatment of Patients With Onychomycosis With Contraindications to Systemic Antimycotics

Abstract

The aim: To increase the effectiveness of treatment of patients with onychomycosis with contraindications to administration of systemic antifungal therapy. Materials and methods: The study involved 63 patients with onychomycosis of the toes aged 18 to 72 years under supervision at the clinic of the Institute of Dermatology and Venereology of the National Academy of Medical Sciences of Ukraine, who were divided into groups: Group I (30 patients) received naftifine hydrochloride solution and cream; Group II (33 patients) additionally used nail kit mycosan and cytoflavin 2 tablets 2 times a day for 1-1.5 months.The study implied microscopic and molecular genetic examination of nail plates before treatment and starting from the 4th week every 2 weeks. The study included patients with onychomycosis with positive results of both microscopic and PCR studies. Mycological recovery was noted in case of coincidence of results of these studies. Results: Mycological recovery in patients of Group II began in the sixth week in 6.3% and occurred in 100% of cases at the 24th week of treatment, depending on the severity and clinical form. The overall effectiveness of therapy at the 48th week reached 56.7% in Group I and 72.7% in Group II. Conclusions: The developed method of treatment, which includes the use of naftifine hydrochloride solution and cream, nail kit micozan and cytoflavin, allows to achieve clinical and mycological recovery in 72.7% of patients and is a priority in the treatment of patients with onychomycosis with comorbid conditions.