Abstract
Background: Recurrences (relapse or reinfection) of onychomycosis are not uncommon, with percentages reported in various studies ranging from 10% to 53%. Objective: We sought to determine the prevalence of long-term recurrences of toenail onychomycosis caused by dermatophytes cured after systemic antifungal treatment with terbinafine (T) or itraconazole (I) and identify risk factors for recurrences. Methods: This 7-year prospective study, started in 2000 and ended in 2007, included 73 patients periodically followed after successful treatment of toenail onychomycosis using either T, 250 mg daily (59 patients), or I, 400 mg daily, for 1 week per month (14 patients). Patients were evaluated every 6 months, with clinical and mycological evaluations being performed. Results: Twelve of 73 patients (16.4%) developed a recurrence of onychomycosis a mean time of 36 months after successful treatment. These included 5 of the 14 patients (35.7%) who had taken I and 7 of the 59 (11.9%) who had taken T (P = .046). Limitations: The number of patients treated with T (59 patients) was more than that for I (14 patients). Conclusion: The administration of systemic T to treat the first episode of onychomycosis may provide better long-term success than I in those patients with a complete response. Other factors including the presence of predisposing factors, use of nail lacquer as a prophylactic treatment, and the dermatophyte strain isolated were not significantly related to relapse.
| Original language | English |
|---|---|
| Pages (from-to) | 411-414 |
| Number of pages | 4 |
| Journal | Journal of the American Academy of Dermatology |
| Volume | 62 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 1 2010 |
| Externally published | Yes |
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Keywords
- amorolfine nail lacquer
- dermatophytes
- itraconazole
- systemic antifungal
- terbinafine
- toenail onychomycosis
ASJC Scopus subject areas
- Dermatology
Cite this
Long-term follow-up of toenail onychomycosis caused by dermatophytes after successful treatment with systemic antifungal agents. / Piraccini, Bianca Maria; Sisti, Andrea; Tosti, Antonella.
In: Journal of the American Academy of Dermatology, Vol. 62, No. 3, 01.03.2010, p. 411-414.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Long-term follow-up of toenail onychomycosis caused by dermatophytes after successful treatment with systemic antifungal agents
AU - Piraccini, Bianca Maria
AU - Sisti, Andrea
AU - Tosti, Antonella
PY - 2010/3/1
Y1 - 2010/3/1
N2 - Background: Recurrences (relapse or reinfection) of onychomycosis are not uncommon, with percentages reported in various studies ranging from 10% to 53%. Objective: We sought to determine the prevalence of long-term recurrences of toenail onychomycosis caused by dermatophytes cured after systemic antifungal treatment with terbinafine (T) or itraconazole (I) and identify risk factors for recurrences. Methods: This 7-year prospective study, started in 2000 and ended in 2007, included 73 patients periodically followed after successful treatment of toenail onychomycosis using either T, 250 mg daily (59 patients), or I, 400 mg daily, for 1 week per month (14 patients). Patients were evaluated every 6 months, with clinical and mycological evaluations being performed. Results: Twelve of 73 patients (16.4%) developed a recurrence of onychomycosis a mean time of 36 months after successful treatment. These included 5 of the 14 patients (35.7%) who had taken I and 7 of the 59 (11.9%) who had taken T (P = .046). Limitations: The number of patients treated with T (59 patients) was more than that for I (14 patients). Conclusion: The administration of systemic T to treat the first episode of onychomycosis may provide better long-term success than I in those patients with a complete response. Other factors including the presence of predisposing factors, use of nail lacquer as a prophylactic treatment, and the dermatophyte strain isolated were not significantly related to relapse.
AB - Background: Recurrences (relapse or reinfection) of onychomycosis are not uncommon, with percentages reported in various studies ranging from 10% to 53%. Objective: We sought to determine the prevalence of long-term recurrences of toenail onychomycosis caused by dermatophytes cured after systemic antifungal treatment with terbinafine (T) or itraconazole (I) and identify risk factors for recurrences. Methods: This 7-year prospective study, started in 2000 and ended in 2007, included 73 patients periodically followed after successful treatment of toenail onychomycosis using either T, 250 mg daily (59 patients), or I, 400 mg daily, for 1 week per month (14 patients). Patients were evaluated every 6 months, with clinical and mycological evaluations being performed. Results: Twelve of 73 patients (16.4%) developed a recurrence of onychomycosis a mean time of 36 months after successful treatment. These included 5 of the 14 patients (35.7%) who had taken I and 7 of the 59 (11.9%) who had taken T (P = .046). Limitations: The number of patients treated with T (59 patients) was more than that for I (14 patients). Conclusion: The administration of systemic T to treat the first episode of onychomycosis may provide better long-term success than I in those patients with a complete response. Other factors including the presence of predisposing factors, use of nail lacquer as a prophylactic treatment, and the dermatophyte strain isolated were not significantly related to relapse.
KW - amorolfine nail lacquer
KW - dermatophytes
KW - itraconazole
KW - systemic antifungal
KW - terbinafine
KW - toenail onychomycosis
UR - http://www.scopus.com/inward/record.url?scp=76249111790&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=76249111790&partnerID=8YFLogxK
U2 - 10.1016/j.jaad.2009.04.062
DO - 10.1016/j.jaad.2009.04.062
M3 - Article
C2 - 20159308
AN - SCOPUS:76249111790
VL - 62
SP - 411
EP - 414
JO - Journal of the American Academy of Dermatology
JF - Journal of the American Academy of Dermatology
SN - 0190-9622
IS - 3
ER -