• 1.

    Scher RK, Coppa LM: Advances in the diagnosis and treatment of onychomycosis. Hosp Med 34: 11, 1998.

  • 2.

    Ghannoum MA, Hajjeh RA, Scher R, et al: A large-scale North American study of fungal isolates from nails: the frequency of onychomycosis, fungal distribution, and antifungal susceptibility patterns. J Am Acad Dermatol 43: 641, 2000.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Mozena J: A guide to treatments for onychomycosis. Podiatry Today 2003; 16(8).

  • 4.

    Baran R, Sigurgeirsson B, de Berker D, et al: A multicentre, randomized, controlled study of the efficacy, safety and cost-effectiveness of a combination therapy with amorolfine nail lacquer and oral terbinafine compared with oral terbinafine alone for the treatment of onychomycosis with matrix involvement. Br J Dermatol 157: 149, 2007.

    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 5.

    Prescrire R: Fungal nail infections: diagnosis and management. Prescrire Int 18: 26, 2009.

  • 6.

    de Berker D: Fungal nail disease. N Engl J Med 360: 2108, 2009.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 7.

    Ghannoum MA, Long L, Pfister WR: Determination of the efficacy of terbinafine hydrochloride nail solution in the topical treatment of dermatophytosis in a guinea pig model. Mycoses 52: 35, 2009.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 8.

    Elewski BE, Ghannou MA, Mayser P, et al: Efficacy, safety and tolerability of topical terbinafine nail solution in patients with mild-to-moderate toenail onychomycosis: results from three randomized studies using double-blind vehicle-controlled and open-label active-controlled designs. J Eur Acad Dermatol Venereol 27: 287, 2013.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 9.

    Elewski BE, Rich P, Pollak R, et al: Efinaconazole 10% solution in the treatment of toenail onychomycosis: two phase 3 multicenter, randomized, double-blind studies. J Am Acad Dermatol 68: 600, 2013.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 10.

    De Cuyper C, Hindryckx PH: Long-term outcomes in the treatment of toenail onychomycosis. Br J Dermatol 141(Suppl 56): 15, 1999.

  • 11.

    Werschler WP, Bondar G, Armstrong D: Assessing treatment outcomes in toenail onychomycosis clinical trials. Am J Clin Dermatol 5: 145, 2004.

  • 12.

    Piraccini BM, Sisti A, Tosti A: Long-term follow-up of toenail onychomycosis caused by dermatophytes after successful treatment with systemic antifungal agents. J Am Acad Dermatol 62: 411, 2010.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 13.

    Gupta AK, Schouton, JR, Jynch LE: Ciclopirox nail lacquer 8% for the treatment of onychomycosis: a Canadian perspective. Skin Therapy Lett 10: 1, 2005.

  • 14.

    Gupta AK, Joseph WS: Ciclopirox 8% nail lacquer in the treatment of onychomycosis of the toenails in the United States. JAPMA 90: 495, 2000.

Topical Treatment of Onychomycosis as a Realistic Option to Systemic Therapy

A Case Report

Aditya K. Gupta Mediprobe Research Inc, 645 Windemere Road, London, Ontario, Canada
Mediprobe Research Inc, 645 Windemere Road, London, Ontario, Canada

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 MD, PhD, FAAD, FRCPC

Onychomycosis is a very common disease, especially in podiatric medical practice. It can be associated with significant patient distress, major disability and pain, and is challenging to treat successfully. This is a case study of a 41-year-old man with distal lateral subungual onychomycosis of 5 years' duration. Forty percent of the great toenail was affected and a total of six toenails were involved. Baseline fungal cultures were positive for Trichophyton rubrum. This patient was treated with efinaconazole 10% solution, a new topical antifungal, once daily for 48 weeks. Mycological cure was noted at the first assessment period (12 weeks), and compete cure was seen at follow-up. This case study alerts physicians to a promising new topical treatment for onychomycosis under development, and to the importance of mycological cure as an early indicator of treatment success.

Aditya K. Gupta, MD, PhD, FAAD, FRCPC, Mediprobe Research Inc, 645 Windemere Road, London, Ontario, Canada. (Email: agupta@mediproberesearch.com; agupta@execulink.com)
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