J Drugs Dermatol. 2021 Oct 1;20(10):1076-1084. doi: 10.36849/JDD.6291.
Onychomycosis affects around 14% of individuals in North America and Europe and is undertreated. Treatment is challenging as toenail growth can take 12–18 months, the nail plate may prevent drug penetration, and disease recurrence is common. National guidelines/consensus documents on onychomycosis diagnosis and treatment were last published more than 5 years ago and updated medical guidance is needed.
This document aims to provide recommendations for the diagnosis and pharmaceutical treatment of toenail onychomycosis following a roundtable discussion with a panel of dermatologists, podiatrists, and a microbiologist specializing in nail disease.
There was a general consensus on several topics regarding onychomycosis diagnosis, confirmatory laboratory testing, and medications. Onychomycosis should be assessed clinically and confirmed with microscopy, histology, and/or culture. Terbinafine is the primary choice for oral treatment and efinaconazole 10% for topical treatment. Efinaconazole can also be considered for off-label use for maintenance to prevent recurrences. For optimal outcomes, patients should be counseled regarding treatment expectations as well as follow-up care and maintenance post-treatment.
This article provides important updates to previous guidelines/consensus documents to assist dermatologists and podiatrists in the diagnosis and treatment of toenail onychomycosis. J Drugs Dermatol. 2021;20(10):1076-1084. doi:10.36849/JDD.6291.
甲真菌病影响北美和欧洲约 14%的个体，且治疗不足。治疗具有挑战性，因为趾甲生长需要 12-18 个月，指甲板可能会阻碍药物渗透，且疾病复发很常见。关于甲真菌病诊断和治疗的国家指南/共识文件上次发布是在 5 年多前，需要更新医学指导。
本文旨在通过与一组皮肤科医生、足病医生和专门研究指甲疾病的微生物学家进行圆桌讨论，为趾甲甲真菌病的诊断和药物治疗提供建议。
对于甲真菌病的诊断、确认性实验室检测和药物治疗，专家组达成了一些共识。甲真菌病应进行临床评估，并通过显微镜检查、组织学检查和/或培养进行确认。特比萘芬是口服治疗的主要选择，而 10%伊曲康唑是外用治疗的主要选择。伊曲康唑也可考虑用于预防复发的标签外维持治疗。为了获得最佳结果，应向患者提供有关治疗预期以及治疗后随访护理和维持的咨询。
本文为皮肤科医生和足病医生提供了重要的更新，以协助诊断和治疗趾甲甲真菌病。J 皮肤病药物治疗杂志。2021;20(10):1076-1084.doi:10.36849/JDD.6291.
