Update on current approaches to diagnosis and treatment of onychomycosis

Gupta, Aditya K.; Mays, Rachel; Versteeg, Sarah G.; Shear, Neil H.; Piguet, Vincent

doi:10.1080/14787210.2018.1544891

Cited by 54 publications

(94 citation statements)

References 62 publications

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“…The term “onychomycosis” is derived from the Greek words “ onyx ” meaning nail and “ mykes ” meaning fungus [ 4 ]. Onychomycosis is the most common disorder affecting the nail unit and accounts for at least 50% of all nail diseases [ 2 , 5 , 6 ]. Laboratory confirmation of the clinical diagnosis of onychomycosis prior to initiating treatment is cost effective and is recommended [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Onychomycosis: An Updated Review

Leung

Lam

Leung

et al. 2020

IAD

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Background : Onychomycosis is a common fungal infection of the nail. Objective: The study aimed to provide an update on the evaluation, diagnosis, and treatment of onychomycosis. Methods: A PubMed search was completed in Clinical Queries using the key term “onychomycosis”. The search was conducted in May 2019. The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews published within the past 20 years. The search was restricted to English literature. Patents were searched using the key term “onychomycosis” in www.freepatentsonline.com. Results : Onychomycosis is a fungal infection of the nail unit. Approximately 90% of toenail and 75% of fingernail onychomycosis are caused by dermatophytes, notably Trichophyton mentagrophytes and Trichophyton rubrum. Clinical manifestations include discoloration of the nail, subungual hyperkeratosis, onycholysis, and onychauxis. The diagnosis can be confirmed by direct microscopic examination with a potassium hydroxide wet-mount preparation, histopathologic examination of the trimmed affected nail plate with a periodic-acid-Schiff stain, fungal culture, or polymerase chain reaction assays. Laboratory confirmation of onychomycosis before beginning a treatment regimen should be considered. Currently, oral terbinafine is the treatment of choice, followed by oral itraconazole. In general, topical monotherapy can be considered for mild to moderate onychomycosis and is a therapeutic option when oral antifungal agents are contraindicated or cannot be tolerated. Recent patents related to the management of onychomycosis are also discussed. Conclusion: Oral antifungal therapies are effective, but significant adverse effects limit their use. Although topical antifungal therapies have minimal adverse events, they are less effective than oral antifungal therapies, due to poor nail penetration. Therefore, there is a need for exploring more effective and/or alternative treatment modalities for the treatment of onychomycosis which are safer and more effective.

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Section: Introductionmentioning

confidence: 99%

Onychomycosis: An Updated Review

Leung

Lam

Leung

et al. 2020

IAD

View full text Add to dashboard Cite

show abstract

“…Onychomycosis is a frequent health problem worldwide with a prevalence that varies between different parts of the world according to climate, cultural factors and socioeconomic status [1] In a study in Assuit, Egypt, Moubasher et al demonstrated that onychomycosis was the most frequent fungal dermatological infection accounting for 64.8% of the 125 studied cases, followed by tinea capitis [14]. Onychomycosis is not a life-threatening condition; nevertheless, it precludes the quality of life of the patients affected, as it causes nail disfigurement, and psychological discomfort [15].…”

Section: Discussionmentioning

confidence: 99%

“…Candidal onychomycosis occurs more commonly in fingernails in people with frequent water exposure [2]. Meanwhile, dermatophytes are the fungi most commonly responsible for onychomycosis in the Western countries [1]. Moubasher et al reported that non-dermatophytic moulds are important pathogens for skin and nail superficial mycosis in Assiut, Egypt as they followed yeasts and preceded dermatophytes as etiologies of mycotic infections [14].…”

Section: Onychomycosismentioning

confidence: 99%

“…Dermatophytes, especially of genus Trichophyton, account for most of the cases [1]. Other pathogens like candida and non-dermatophytic moulds are more frequent in countries with hot and humid climate [2].…”

Section: Introductionmentioning

confidence: 99%

“…Nail diseases like psoriasis, lichen planus and chronic nail trauma may mimic onychomycosis. Thus, an accurate diagnosis is crucial for a successful treatment of onychomycosis, making a laboratory identification via direct microscopy and fungal culture is a must [1].…”

Section: Introductionmentioning

confidence: 99%

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