Murdan Sudaxshina
University of London, The School of Pharmacy, Department of Pharmaceutics, 29 - 39 Brunswick Square, London.
Expert Opin Drug Deliv. 2008 Nov;5(11):1267-82. doi: 10.1517/17425240802497218.
The topical therapy of nail diseases, especially of onychomycosis, and to a smaller extent, of nail psoriasis, is desirable to avoid the side effects associated with their systemic therapy, to increase patient compliance and reduce the cost of treatment. Systemic therapy is however the mainstay of treatment due to the poor permeability of the nail plate to topically applied drugs. For effective topical therapy, ungual drug permeation must be enhanced. This can be achieved by disrupting the nail plate using physical techniques or chemical agents. Alternatively, drug permeation into the intact nail plate may be encouraged, for example, by iontophoresis or by formulating the drug within a vehicle which enables high drug partition out of the vehicle and into the nail plate. The physical techniques (manual and electrical nail abrasion, acid etching, ablation by lasers, microporation, application of low-frequency ultrasound and electric currents) and chemicals (thiols, sulphites, hydrogen peroxide, urea, water, enzymes) that have shown ungual enhancer activity are discussed in this review. Optimal drug formulation, while crucial to ungual drug delivery, is only briefly reviewed due to the limited literature.
指甲疾病的局部治疗，尤其是甲癣，以及在较小程度上的甲银屑病，是很有必要的，这样可以避免全身治疗带来的副作用，提高患者的依从性并降低治疗成本。然而，由于甲板对局部应用药物的渗透性较差，全身治疗仍是主要的治疗方法。为了实现有效的局部治疗，必须增强指甲药物渗透。这可以通过使用物理技术或化学试剂破坏甲板来实现。或者，可以促进药物渗透到完整的甲板中，例如通过离子导入法，或者通过将药物配制在一种载体中，这种载体能够使药物从载体中大量分配到甲板中。本文综述了已显示出指甲增强活性的物理技术（手动和电动指甲磨损、酸蚀、激光消融、微孔化、低频超声和电流应用）和化学物质（硫醇、亚硫酸盐、过氧化氢、尿素、水、酶）。最佳药物制剂虽然对指甲药物递送至关重要，但由于文献有限，仅作简要综述。
