Difonzo Elisa M, Scarfì Federica, Galeone Massimiliano
Division of Dermatology, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy -
Division of Dermatology, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy.
G Ital Dermatol Venereol. 2017 Oct;152(5):432-435. doi: 10.23736/S0392-0488.17.05456-6.
In order to treat onychomycosis, topical and systemic medications are available. The choice of a systemic or topic treatment depends on numerous factors, such as patient's age, the presence of comorbidity, responsible fungal species, the clinical form of onychomycosis, its location (fingernails or toenails), the number of nails affected and the percentage of the nail plate infected. As for topical medications, given that nail plate has an insufficiently permeable structure, it is necessary to use appropriate formulae that create in the surface of the nail plate a film able, in turn, to function both as an active ingredient's deposit and moisturising agent in nail's superficial layers in order to facilitate the spread of the active ingredient. In this manuscript, we wanted to evaluate the effectiveness and tolerability rate of a new topical formulation (Miconal Nails®, Morgan srl, Vicenza, Italy) composed of hydrogenated castor oil, hydroxyethyl cellulose, and other ingredients (urea, climbazole, piroctone olamine, undecylenic acid).
We selected 25 patients of both sexes whose median age was between 20 and 70 years, and were affected by onychomycosis in a single toe. Their onychomycosis was a distolateral subungual type (with a <50% invasion of nail plate and sparing of lunula) and white superficial. The treatment was evaluated with the following possible outcomes: complete healing, improvement, stationarity, worsening.
Patients were 11 female subjects and 14 male subjects, whose median age was 45. A complete healing was achieved in 15 patients. In 3 cases the clinical presentation appeared unchanged with a persistence of mycological evidence. The response to the treatment was assessed as improvement in 7 patients.
In our experience, this new product is an effective weapon that enhances the therapeutic selection of topical formulae for treating onychomycosis. If used alone in the cases that meet inclusion criteria for topical treatment, it allowed us to achieve a complete healing just with a 5-month treatment in 60% of cases, data that reached 76% on the follow-up visit.
为治疗甲癣，有局部用药和全身用药可供选择。全身治疗或局部治疗的选择取决于众多因素，如患者年龄、合并症的存在、致病真菌种类、甲癣的临床类型、其部位（手指甲或脚趾甲）、受累指甲数量以及甲板感染的百分比。至于局部用药，鉴于甲板结构的渗透性不足，有必要使用合适的配方，在甲板表面形成一层膜，该膜既能作为活性成分的储存库，又能作为指甲表层的保湿剂，以促进活性成分的扩散。在本手稿中，我们想评估一种由氢化蓖麻油、羟乙基纤维素和其他成分（尿素、克霉唑、吡罗克酮乙醇胺、十一烯酸）组成的新型局部制剂（Miconal Nails®，Morgan srl，意大利维琴察）的有效性和耐受性。
我们选择了25名年龄中位数在20至70岁之间、单趾患有甲癣的男女患者。他们的甲癣为远端外侧甲下型（甲板侵犯<50%且半月痕未受累）和白色浅表型。治疗评估有以下可能结果：完全愈合、改善、病情稳定、恶化。
患者中有11名女性和14名男性，年龄中位数为45岁。1️⃣5名患者实现了完全愈合。3例临床表现未改变，真菌学证据持续存在。7名患者的治疗反应被评估为改善。
根据我们的经验，这种新产品是一种有效的武器，可增强治疗甲癣的局部配方的治疗选择。如果在符合局部治疗纳入标准的病例中单独使用，在60%的病例中仅通过5个月的治疗就能实现完全愈合，随访时这一数据达到76%。
