Dermatol. praxi. 2011;5(2):64-68 [Med. praxi. 2011;8(2):73-76]
Etiology, clinical features and treatment of onychomycosis
- Centrum pro léčbu dermatomykóz, Dermatovenerologická klinika 1. LF UK a VFN, Praha
Onychomycosis is an infection of the nail apparatus by microscopic fungi that include dermatophytes, yeasts (mainly Candida species) and nondermatophyte moulds. Dermatophyte infection, mostly due to Trichophyton rubrum, is the cause in over 90 % of cases. The distribution of different pathogens depends on various factors such as climate, geography, migration, diabetes, acquired immunodeficiency syndrome and peripheral arterial disease. Laboratory diagnosis consists of microscopy to visualize fungal elements (mycelia and spores) in the nail sample and culture to identify the species concerned. Systemic therapy is almost always more successful than topical treatment, which should only be used in very early DLSO and SWO, or when systemic therapy is contraindicated.
Keywords: onychomycosis, clinical picture, therapy
Published: June 1, 2011 Show citation
References
- Baran R, Hay RJ, Garduno JI. Review of antifungal therapy, part II: treatment rationale, including specific patient populations. J Dermatolog Treat 2008; 19(3): 168-175.
Go to original source... 
Go to PubMed... - Borelli C, Schaller M, Niewerth M, et al. Modes of action of the new arylguanidine abafungin beyond interference with ergosterol biosynthesis and in vitro activity against medically important fungi. Chemotherapy. 2008; 54: 245-259. Go to original source... Go to PubMed...
- Elewski B. Diagnostic techniques for confirming onychomycosis. J Am Acad Dermatol 1996; 35(2): 6-9. Go to original source... Go to PubMed...
- Gupta AK, Lambert J, Revuz J, Shear N. Update on the safety of itraconazole pulse therapy in onychomycosis and dermatomycoses. Eur J Dermatol. 2001; 11(1): 6-10.
- Gupta AK, Shear NH. A risk-benefit assessment of the newer oral antifungal agents used to treat onychomycosis. Drug Saf 2000; 22(1): 33-52. Go to original source... Go to PubMed...
- Jedličková A, Mašata J, Skořepová M. Lokální mykózy. Praha: Jessenius Maxdorf, 2008.
- Kuklová I, Kučerová H. Fungal infections in Prague, Czech Republic, between 1987 and 1998. Mycoses 2001; 44: 493-496. Go to original source... Go to PubMed...
- Litvik R. Lokální a systémová léčba onychomykóz - doporučení pro praxi. Remedia on line, 1/2009.
- Roberts DT, Taylor WD, Boyle J. Guidelines for treatment of onychomycosis. Br J Dermatol 2003; 148: 402-410. Go to original source... Go to PubMed...
- Scher RK, Baran R. Onychomycosis in clinical practice: factors contributing to recurrence. Br J Dermatol 2003; 149(Suppl. s 65): 5-9. Go to original source... Go to PubMed...
- Smijs TG, Pavel S. The susceptibility of dermatophytes to photodynamic treatment with special focus on Trichophyton rubrum. Photochem Photobiol 2011; 87(1): 2-13. Go to original source... Go to PubMed...