Ultrastructural Changes in Onychomycosis during the Treatment with Bifonazole/Urea Ointment

Fritsch, Helga; Stettendorf, S.; L, Hegemann

doi:10.1159/000247399

Cited by 12 publications

(4 citation statements)

References 6 publications

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“…The application of urea, through hydration of the nail plate, causes visible changes. An ultrastructural study of the effects of 40% urea showed that there was considerable disruption of the cell/cell adhesion of corneocytes in the nail plate 19 accounting for visible urea‐associated nail plate change. Therefore, in judging clinical response, the visual appearance of the nail bed after therapy involving urea cannot be rated as ‘normal’ until the morphological changes due to nail plate ablation have faded.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of 4 weeks topical bifonazole treatment for onychomycosis after nail ablation with 40% urea: a double‐blind, randomized, placebo‐controlled multicenter study

Tietz¹,

Hay

Querner

et al. 2013

Mycoses

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Onychomycosis is a common fungal infection most often affecting the toenails. If untreated, it can cause discomfort sufficient to reduce quality of life. To evaluate efficacy and safety of bifonazole cream vs. placebo in onychomycosis treatment after non-surgical nail ablation with urea paste. Fifty-one study centres randomized 692 subjects with mild-to-moderate onychomycosis to receive bifonazole 1% cream or placebo for 4 weeks following non-surgical nail ablation with urea 40% paste over 2-4 weeks. Efficacy of the two phase treatment was evaluated by overall cure of the target nail comprising clinical and mycological cure 2 weeks, 3 and 6 months after end of treatment. At 2 weeks (primary endpoint), overall cure rate was superior in bifonazole-treated group (54.8% vs. 42.2% for placebo; P = 0.0024). The clinical cure rate was high in both treatment groups (86.6% bifonazole vs. 82.8% placebo), but proportion with mycological cure was higher with bifonazole treatment (64.5%) vs. placebo treatment 49.0%, (P = 0.0001). We observed higher early overall cure rate with 4 weeks topical bifonazole compared with placebo after removal of infected nail parts with urea. This two stage treatment was well tolerated and offers an additional option in topical onychomycosis therapy.

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Section: Discussionmentioning

confidence: 99%

Efficacy of 4 weeks topical bifonazole treatment for onychomycosis after nail ablation with 40% urea: a double‐blind, randomized, placebo‐controlled multicenter study

Tietz¹,

Hay

Querner

et al. 2013

Mycoses

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“…Several such micrographs were used in the present study. It is known that the surfaces of normal nails present a squamous polygonal appearance with well-defined intercellular boundaries [6,13].…”

Section: Scanning Electron Microscopymentioning

confidence: 99%

Anatomic considerations of the human nail

McCarthy¹

2004

Clinics in Podiatric Medicine and Surgery

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“…[27][28][29][30][31] One of the most widely used antifungal-urea combinations evaluated in several small-scale trials is 1% bifonazole in combination with 40% urea ointment. [27][28][29][30][31] One of the most widely used antifungal-urea combinations evaluated in several small-scale trials is 1% bifonazole in combination with 40% urea ointment.…”

Section: Topical Antifungal Agentsmentioning

confidence: 99%

Topical Treatments for Onychomycosis

Bodman

Feder²,

Nace³

2003

Journal of the American Podiatric Medical Association

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Topical treatment of onychomycosis, in contrast to systemic oral therapy, allows the patient to apply medication directly to the affected area, thereby decreasing the potential for adverse events and drug interactions. Historically, several topical antifungal agents have been used in the treatment of onychomycosis; however, the evidence for their effectiveness is based on very limited data or anecdotal reports. Recently, the development of new, effective topical agents has renewed interest in this form of therapy. As clinical experience with newer topical agents expands, they may be found to be an effective option for the treatment of onychomycosis.

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Ultrastructural Changes in Onychomycosis during the Treatment with Bifonazole/Urea Ointment

Cited by 12 publications

References 6 publications

Efficacy of 4 weeks topical bifonazole treatment for onychomycosis after nail ablation with 40% urea: a double‐blind, randomized, placebo‐controlled multicenter study

Efficacy of 4 weeks topical bifonazole treatment for onychomycosis after nail ablation with 40% urea: a double‐blind, randomized, placebo‐controlled multicenter study

Anatomic considerations of the human nail

Topical Treatments for Onychomycosis

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