COMPLEX LOCAL TREATMENT OF THE FEET ONICHOMICOSIS

Abstract

The purpose of the research. To investigate the effectiveness of complex topicalapplication of antifungal drugs in the treatment of the feet onychomycosis.Material and methods. We examined 46 patients with onychomycosis of the feet (28 menand 18 women aged from 18 to 60 years), in whom the duration of the disease is up to 5years. Criteria for inclusion in the study: microscopically confirmed fungal infection to 2nails; superficial, distal-lateral types of onychomycosis; disease duration not more than 5years. Exclusion criteria: a combination of onychomycosis and mycosis of the skin of thefeet; total onychomycosis; individual intolerance to drugs; the presence of severeconcomitant pathology of the vessels of the lower extremities. In 36 patients (78%), thelateral distal type of onychomycosis was detected, in 10 patients (22%) - superficialdamage of the nails. A cultural study on the Saburo medium identified T. rubrum in 39patients (85%), T. interdigitale - in 5 patients (11%) and Candida spp. - in 2 patients(4%). For the combined local treatment of onychomycosis we chose Onychocid® Emtrixand Cyclocutan. A thin layer of Onychocid® Emtrix solution was applied to the affectednails daily at bedtime for 3 months. Cyclocutan, the release form of which is varnish, wasprescribed after treatment of Onychocid Emtrix. The first 8 weeks, the patients appliedvarnish on the affected nails every other day, from 9 to 20 weeks - twice a week. After thefirst visit, patients returned after 3, 6 and 8 months. From the begining of treatment weevaluated the dynamics of treatment, the condition and appearance of the nail plate, andperformed nail microscopy.Results. Clinical improvement of the nails after 3 months of treatment was noted in 32patients (70%), after 6 months - in 39 patients (85%). After 8 months of therapy, clinicalimprovement of the nails was observed in 45 patients (98%). During this time, the affectednail plates grew by 30-45%, the proximal part was visually healthy. The examinationrevealed, that the nails became less thickened, their fragility decreased, they becamesmooth, transparent, the color of the nail plates approached the natural one. Patientsnoted a decrease in symptoms and denied any adverse reactions from antifungal drugs.Nail microscopy was performed after 8 months of the local therapy and did not find mycotic infection in 39 (85%) patients with past distal-lateral and superficial onychomycosis.During the entire period of treatment, the visible signs of fungal infection regressed, thenails as a whole acquired a more homogeneous structure and smoothness.Conclusions. During treatment, the typical signs of a fungal nail infection regressed. Inparticular, the surface of the nail has become more smooth and shiny, the color - evenlylight pink. The free edge of the nail plate changed from brittle to smooth and durable, thestructure became homogeneous.