Gupta Aditya K, Venkataraman Maanasa, Quinlan Emma M, Gupta Madhulika A, Anbalagan Naveen, Lyons Rachel
Department of Dermatology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Mediprobe Research Inc., London, Ontario, Canada.
Skin Appendage Disord. 2021 Jun;7(4):272-279. doi: 10.1159/000514361. Epub 2021 May 19.
Onychomycosis is a common, difficult-to-treat fungal nail infection. Clinical signs include nail discoloration and thickening, which patients often find embarrassing, causing a negative impact on their quality of life (QOL).
In this post hoc study, we analyze the effect of efinaconazole 10% solution on a patient's QOL using patient-reported scores from the OnyCOE-t™ questionnaire (appearance, stigma, physical problems, symptom frequency, symptom bothersomeness, treatment satisfaction, and overall problem). Higher scores corresponded to better functioning, thus higher QOL.
Efinaconazole 10% treatment and clinical efficacy were positively correlated with improved QOL in all domains for all groups, except with symptom bothersomeness (how much the onychomycosis symptoms worried or concerned the patient) for female patients <40 years. While still showing improvement in most domains during efficacious treatment, female and younger patients reported lower QOL scores than their male and older counterparts, despite having better clinical outcomes at follow-ups.
Female and younger patients appear to be more emotionally bothered by their symptoms, regardless of treatment success or improvement of their nail's appearance, suggesting that onychomycosis is more than nail deep and has a greater psychological effect on these patients. Therefore, younger female patients may require more assurance and mental support.
甲癣是一种常见且难以治疗的指甲真菌感染。临床症状包括指甲变色和增厚，患者常常觉得这些症状令人尴尬，对他们的生活质量（QOL）产生负面影响。
在这项事后分析研究中，我们使用来自OnyCOE-t™问卷（外观、耻辱感、身体问题、症状频率、症状困扰、治疗满意度和总体问题）的患者报告评分，分析10%艾氟康唑溶液对患者生活质量的影响。分数越高表明功能越好，即生活质量越高。
10%艾氟康唑治疗和临床疗效与所有组在所有领域的生活质量改善呈正相关，但40岁以下女性患者的症状困扰（甲癣症状使患者担心或困扰的程度）除外。尽管在有效治疗期间大多数领域仍有改善，但女性和年轻患者报告的生活质量得分低于男性和年长患者，尽管他们在随访时临床结果更好。
女性和年轻患者似乎在情感上更容易受到症状的困扰，无论治疗是否成功或指甲外观是否改善，这表明甲癣不仅仅局限于指甲本身，对这些患者有更大的心理影响。因此，年轻女性患者可能需要更多的保证和心理支持。
