MYCOLOGY: AN UPDATE 

Giornale Italiano di Dermatologia e Venereologia 2013 December;148(6):633-8

Copyright © 2014 EDIZIONI MINERVA MEDICA

language: English

Update on the management of onychomycosis

Piraccini B. M. ¹, Gianni C. ² ✉

¹ Division of Dermatology, Department of Experimental Diagnostic and Specialty Medicine University of Bologna, Bologna, Italy; ² Unit of Dermatology Italian Diagnostic Center (CDI), Milan, Italy

Onychomycosis is a fungal infection of the nail which is highly prevalent in the general population, particularly among older individuals. Patients seek care because the disease is infectious or simply for an esthetic discomfort. The difficulty in treating onychomycosis results from the deep-seated nature of the infection within the nail unit and the inability of drugs to effectively reach all sites. Present treatment options include both oral and topical drugs, with oral therapies giving better outcomes. New derivatives with a favorable risk-benefit ratio and new formulations of older azoles seem to be promising. The research for new drugs or formulations has the objective of discovering new active antifungals or new technologies to facilitate incorporation or persistence of existing antifungal drugs inside the nail plate. In fact, the same antimycotics that heal skin fungal infections are rendered less efficacious in nail disease. This update has the aim to synthesize and focus the therapies currently in use and new therapeutic approaches on onychomycosis. It also summarizes the newer areas of research in the treatment of onychomycosis as photodynamic and laser therapy.