Long-term follow-up of toenail onychomycosis caused by dermatophytes after successful treatment with systemic antifungal agents

Bianca Maria Piraccini, Andrea Sisti, Antonella Tosti

Research output: Contribution to journalArticle

87 Citations (Scopus)

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 languageEnglish
Pages (from-to)411-414
Number of pages4
JournalJournal of the American Academy of Dermatology
Volume62
Issue number3
DOIs
StatePublished - Mar 1 2010
Externally publishedYes

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Onychomycosis
Arthrodermataceae
Antifungal Agents
Nails
Recurrence
Therapeutics
terbinafine
Lacquer
Itraconazole
Causality
Prospective Studies

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 journalArticle

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