Gupta A K, Baran R
Department of Medicine, Sunnybrook and Women's College Health Sciences Center, and University of Toronto, Ontario, Canada.
J Am Acad Dermatol. 2000 Oct;43(4 Suppl):S96-102. doi: 10.1067/mjd.2000.109068.
Ciclopirox nail lacquer solution 8% has been shown to be effective in the treatment of dermatophyte onychomycosis of mild to moderate severity Other studies report the effectiveness of ciclopirox nail lacquer in onychomycosis caused by Candida sp and nondermatophyte molds. Ciclopirox nail lacquer may also be valuable in the treatment of early cases of reinfection/relapse. Ciclopirox nail lacquer solution 8% may be an important adjunct to oral antifungal therapy in certain presentations that might be poorly responsive to oral antifungal therapy alone (eg, lateral onychomycosis, longitudinal spike, dermatophytoma, and extensive onycholysis). In some cases, surgical therapies may need to be considered in addition to, or in preference to, topical nail lacquer treatment. The use of ciclopirox nail lacquer solution 8% as an adjunct to oral antifungal therapy may widen the spectrum of activity of the combination because of the broad spectrum of coverage provided by the lacquer. The use of combination therapy may be synergistic in terms of efficacy, enabling a reduction in the duration and cumulative dosage of oral therapy. This could result in a decrease in the frequency and severity of systemic adverse effects associated with the oral antimycotics and the need to be vigilant about drug interactions. Studies need to be conducted to determine the place of combination oral and topical lacquer therapy in the management of onychomycosis.
8%环吡酮甲涂剂已被证明对治疗轻至中度皮肤癣菌性甲真菌病有效。其他研究报告了环吡酮甲涂剂对念珠菌属和非皮肤癣菌霉菌引起的甲真菌病的有效性。环吡酮甲涂剂在治疗再感染/复发的早期病例中可能也有价值。在某些对单独口服抗真菌治疗反应不佳的情况下(如侧位甲真菌病、纵向嵴、皮肤癣菌瘤和广泛甲分离),8%环吡酮甲涂剂可能是口服抗真菌治疗的重要辅助药物。在某些情况下,可能需要考虑除局部甲涂剂治疗之外或优先于局部甲涂剂治疗的手术治疗方法。由于甲涂剂提供的广泛覆盖范围,将8%环吡酮甲涂剂用作口服抗真菌治疗的辅助药物可能会扩大联合治疗的活性谱。联合治疗在疗效方面可能具有协同作用,从而能够缩短口服治疗的持续时间和累积剂量。这可能会减少与口服抗真菌药物相关的全身不良反应的频率和严重程度,以及对药物相互作用保持警惕的必要性。需要开展研究以确定口服和局部甲涂剂联合治疗在甲真菌病管理中的地位。