Abstract
Onychomycosis is a frequent nail disease caused by dermatophytes, yeasts, and nondermatophyte molds. Trichophyton rubrum, T mentagrophytes, and Epidermophyton floccosum are the most common etiologic agents worldwide. Candida spp are the most frequent among the yeasts. Diagnosis is corroborated by direct microscopic examination, culture, and histomycology with periodic acid-Schiff stain. Other new methods of diagnosis are discussed. Treatment is based on oral antifungals: terbinafine, itraconazole, and fluconazole, including other emerging triazole drugs. Therapeutic outcome with ciclopirox and amorolfine lacquers alone and combined with systemic therapy are also reviewed, as well as the new nail enhancers and physical and chemical removal of the diseased nails.
Copyright 2010 Elsevier Inc. All rights reserved.
MeSH terms
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Administration, Cutaneous
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Administration, Oral
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Antifungal Agents / therapeutic use*
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Ciclopirox
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Drug Administration Schedule
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Drug Therapy, Combination
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Fluconazole / therapeutic use
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Foot Dermatoses / drug therapy*
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Foot Dermatoses / microbiology*
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Humans
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Itraconazole / therapeutic use
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Mitosporic Fungi / drug effects
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Mitosporic Fungi / isolation & purification*
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Morpholines / therapeutic use
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Naphthalenes / therapeutic use
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Onychomycosis / diagnosis*
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Onychomycosis / drug therapy*
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Pyridones / therapeutic use
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Pyrimidines / therapeutic use
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Terbinafine
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Thiazoles / therapeutic use
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Triazoles / therapeutic use
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Voriconazole
Substances
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Antifungal Agents
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Morpholines
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Naphthalenes
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Pyridones
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Pyrimidines
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Thiazoles
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Triazoles
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Ciclopirox
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Itraconazole
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posaconazole
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Fluconazole
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ER 30346
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amorolfine
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Terbinafine
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Voriconazole