Weill Cornell Medical College, New York, New York.
Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
J Am Acad Dermatol. 2021 Nov;85(5):1227-1239. doi: 10.1016/j.jaad.2020.05.143. Epub 2020 Jun 2.
Onychomycosis is the most common nail disorder, often causing physical, emotional, and aesthetic consequences. The effect of both the condition itself and treatment on quality of life has not been well studied.
The objectives of this study were to systematically review the available literature describing the effect of onychomycosis and treatment on quality of life.
We performed a search of the onychomycosis literature published before April 13, 2020. Articles were included in the review if primary data were presented, patient-reported outcome measures were used, and onychomycosis was specifically examined.
Thirty studies were included in the final analysis. Poorest quality-of-life scores were associated with women and fingernail involvement. Quality-of-life scores improved from baseline with all treatment types; there were greater improvements reported with oral treatments compared with topical ones.
This review affirms that onychomycosis significantly influences quality of life, warranting effective treatment. All treatments resulted in quality-of-life improvements; however, studies on oral and topical therapies were of higher quality than those evaluating devices. Increased efforts are needed to understand the effect of the disease and therapy as assessed by validated, nail-specific outcome measures that accurately assess patients' cosmetic, physical, and social difficulties.
甲真菌病是最常见的指甲疾病，常导致身体、情感和美学方面的后果。该疾病本身及其治疗对生活质量的影响尚未得到充分研究。
本研究旨在系统综述描述甲真菌病和治疗对生活质量影响的现有文献。
我们对截至 2020 年 4 月 13 日发表的甲真菌病文献进行了检索。如果有主要数据、使用患者报告的结局测量、专门检查甲真菌病，则将文章纳入综述。
最终分析纳入了 30 项研究。女性和指甲受累与最差的生活质量评分相关。所有治疗类型均从基线开始改善生活质量评分；与局部治疗相比，口服治疗报告的改善更大。
本综述证实甲真菌病显著影响生活质量，需要有效的治疗。所有治疗均改善生活质量评分；然而，口服和局部治疗的研究质量高于评估器械的研究。需要进一步努力，使用经过验证的、专门针对指甲的结局测量来理解疾病和治疗的影响，这些测量能够准确评估患者的美容、身体和社交困难。
