Treatment of onychomycosis

Yang Won Lee

doi:10.5124/jkma.2019.62.7.385

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Lee: Treatment of onychomycosis

Pharmacotherapeutics

J Korean Med Assoc 2019;62(7):385-391.

Published online: 17 July 2019

DOI: https://doi.org/10.5124/jkma.2019.62.7.385

Treatment of onychomycosis

Yang Won Lee, MD

Department of Dermatology, Konkuk University School of Medicine, Seoul, Korea

Corresponding author: Yang Won Lee E-mail: 20050078@kuh.ac.kr

Received 27 June 2019 Accepted 29 June 2019

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Onychomycosis is a fungal nail infection caused by various fungal species, including dermatophytes, non-dermatophytes, and yeast. It is one of most bothersome nail problems, because it may cause permanent deformity of the nail, local pain, paresthesia, and difficulties performing activities of daily living and engaging in social interactions. Additionally, the treatment of onychomycosis is considered to be challenging because of the long duration of treatment, high recurrence and treatment failure rates, and drug interactions. In this article, we review the prognostic factors for onychomycosis treatment, the treatment options that have been approved, and off-label therapies and devices. Furthermore, we describe preventive therapy for recurrence and emerging methods to achieve a high cure rate. For successful treatment of onychomycosis, the risk factors should be clarified according to the patient's status and the clinical characteristics of onychomycosis. Recently, combinations of various treatment options, such as systemic therapy with simultaneous topical antifungal agents and boost therapy, have been reported as effective treatments of onychomycosis. In addition, laser therapy, photodynamic therapy, and plasma therapy have been proposed as emerging curative options. Providing patient-specific treatment based on an understanding of these treatments plays a pivotal role in achieving better treatment results. This article suggested the updated treatment options for onychomycosis to help clinicians make proper plans and achieve better results.

Keywords: Onychomycosis, Antifungal agents, Laser therapy, Therapeutics

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