Management of Onychomycosis in Canada in 2014

Journal of Cutaneous Medicine and Surgery
A K Gupta, Maryse Paquet

Abstract

Onychomycosis has several clinical presentations and is caused by various infectious organisms. To provide guidance for selection of appropriate treatment. The literature on onychomycosis management was reviewed to generate an evidence-based decision tree. Several options are available: terbinafine, itraconazole, fluconazole, ciclopirox 8% nail lacquer, efinaconazole 10% nail solution, and laser therapy. Further studies on lasers are needed before use can be recommended. Nondermatophyte molds or mixed infection can be managed with terbinafine or itraconazole with or without topicals. Itraconazole, fluconazole, and efinaconazole can be used for Candida infection. For dermatophytes, topicals can be considered for mild to moderate onychomycosis. For moderate to severe cases, any oral monotherapy can be used; however, we suggest terbinafine if there is a possibility of a drug interaction. These recommendations can be applied for all ages, immune function, or metabolic status, but proper monitoring and contraindications should be taken into consideration.

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Citations

Apr 11, 2018·Expert Opinion on Drug Metabolism & Toxicology·Aditya K GuptaNeil H Shear
Dec 27, 2018·International Journal of Dermatology·Aditya K GuptaAntonella Tosti
Mar 9, 2017·Journal of the American Podiatric Medical Association·Gökhan OkanGonca Gokdemir
Nov 21, 2018·American Journal of Clinical Dermatology·Aditya K GuptaBianca Maria Piraccini
Mar 26, 2021·Journal of the European Academy of Dermatology and Venereology : JEADV·A K GuptaE M Quinlan

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Methods Mentioned

BETA
electron microscopy

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