Abstract

Onychomycosis is a common infection of the nail, with its prevalence estimated at 20 percent. However, a significant proportion of patients, perhaps as high as 20~40%, is classified as treatment failures and/or relapse following treatment. Several factors such as antifungal resistance, dermatophytoma, preexisting nail dystrophy, reinfection from the surrounding infected tissue can influence the success of a particular monotherapy. Therefore, the combination of antifungal drugs to produce synergistic activity is one possible advance towards achieving higher cure rates. The combination therapies have been known to increase antifungal spectrum and potency of drugs, facilitate drug delivery and reduce fungal load in nail plate. Their final goals are to increase a tolerance and maximize the therapeutic efficacy.

Considering the special circumstance of the nail, the oral/topical combination is the most appropriate, for it increases drug concentration in the nail plate by mutual complementary cooperation. Treatment of onychomycosis requires long-term systemic medication of antifungal agent, and its complete cure rates were only 30~50%. Clinical success rate is determined by patients compliance which depends on treatment method and period. In practice, compliance of long-term treatment was very low, possibly attributable to longer treatment duration. Another challenge was relapse and/or reinfection after cure. The authors have attempted to address the issue concerning the method of treatment and duration of action for oral antifungal agents commonly used in practice today, and whether there is a statisticallysignificant difference among those drugs, based on the studies analyzing patient compliance.

Keywords

Onychomycosis Treatment Patient compliance Problems

KJMM 2005 September;10(3):83-90(8). Epub 2016 February 20
Copyright © 2005 by Korean Journal of Medical Mycology

Language

Korean/English

Author

Yang Won Lee; Department of Dermatology, College of Medicine, Konkuk University, Seoul, Korea
Moo Kyu Suh; Department of Dermatology, College of Medicine, Dongguk University, Gyeongju, Korea
Kwang Hoon Lee; Department of Dermatology, College of Medicine, Yonsei University, Seoul, Korea
Young Ho Won; Department of Dermatology, College of Medicine, Chungnam National University, Daejeon, Korea
Kyu Joong Ahn; Department of Dermatology, College of Medicine, Konkuk University, Seoul, Korea
Ki Hong Kim; Department of Dermatology, College of Medicine, Youngnam University, Daegu, Korea

Corresponding

Kyu Joong Ahn, Department of Dermatology, College of Medicine, Konkuk University, Seoul, Korea. Tel: (02) 2030-5170, Fax: (02) 2030-5179, e-mail: kjahn@kuh.ac.kr

Publication history

Acknowledgements

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.

Yang Won Lee

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

Moo Kyu Suh

Department of Dermatology, College of Medicine, Dongguk University, Gyeongju, Korea

Kwang Hoon Lee

Department of Dermatology, College of Medicine, Yonsei University, Seoul, Korea

Young Ho Won

Department of Dermatology, College of Medicine, Chungnam National University, Daejeon, Korea

Kyu Joong Ahn

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

Ki Hong Kim

Department of Dermatology, College of Medicine, Youngnam University, Daegu, Korea

Since epub date 2016 February 20