De Doncker P, Van Lint J, Dockx P, Roseeuw D
Department of Dermatology, University of Antwerp, Wilrijk, Belgium.
Cutis. 1995 Sep;56(3):180-3.
In an open study, twenty-eight patients with toenail onychomycosis were treated with monthly cycles of 400 mg itraconazole daily for one week for three (n = 5) or four (n = 23) consecutive months. In this patient sample, a total of seventy-one toenails were affected, with a mean nail-plate involvement of 55 percent (range, 20 to 100 percent). Trichophyton rubrum was the most frequently isolated pathogen, followed by T. mentagrophytes. After active therapy, patients were evaluated for a maximum period of two years (mean, twelve months). A total of twenty-six of twenty-eight patients (93 percent) were considered as clinically cured. Of the remaining two patients, one was markedly improved and one appeared to have relapsed. Only three of seventy-one nails still exhibited some pathologic involvement. Of the twenty-six patients considered cured, mycologic examination at the final visit was performed on thirteen and the results were negative in all of them. The remaining clinically cured patients had no mycologic examination at the last visit. This short treatment was well tolerated; the only adverse reaction being a mild headache in one patient. Patients preferred this regimen to receiving daily treatment for three months. Pulse therapy consisting of monthly one-week cycles of 400 mg itraconazole daily for three to four months may offer a new option for treatment of onychomycosis. Further large-scale studies are required to confirm these findings.
在一项开放性研究中，28例趾甲甲癣患者接受治疗，每月服用400mg伊曲康唑，每日1次，连服1周，共治疗3个月（n = 5）或4个月（n = 23）。在该患者样本中，共有71个趾甲受累，甲板受累平均为55%（范围为20%至100%）。红色毛癣菌是最常分离出的病原体，其次是须癣毛癣菌。积极治疗后，对患者进行了最长两年（平均12个月）的评估。28例患者中有26例（93%）被认为临床治愈。其余2例患者中，1例明显改善，1例似乎复发。71个趾甲中只有3个仍有一些病理改变。在被认为治愈的26例患者中，最后一次就诊时对13例进行了真菌学检查，结果均为阴性。其余临床治愈的患者在最后一次就诊时未进行真菌学检查。这种短疗程治疗耐受性良好；唯一的不良反应是1例患者出现轻度头痛。与接受3个月的每日治疗相比，患者更喜欢这种治疗方案。每日服用400mg伊曲康唑，每月1周，共3至4个月的冲击疗法可能为甲癣治疗提供一种新选择。需要进一步的大规模研究来证实这些发现。
