Mycosan: сlinical experience and trends in the topical therapy of onychomicosis

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Objective — to study the effectiveness and safety of the topical antifungal agent Mycosan in monotherapy of patients with onychomycosis and contraindications to the use of systemic antimycotics.Materials and methods. The questionnaires of 154 patients with a distal-lateral clinical form of onychomycosis and a lesion of not more than two nails on one limb treated with the Mycosan nail kit in 6 regional centers were analyzed. Mycosan nail kit was used according to the instructions. The duration of treatment on average was 3—6 months. All patients underwent clinical and laboratory studies before, during and after treatment. The clinical effect of the therapy was evaluated on the basis of the dynamics of clinical symptoms in scores from 0 (no sign) to 3 (significant sign) at the end of the 4th, 8th, 16th, 24th weeks. Mycological studies were also conducted at these times.Results and discussion. Studies have shown that the use of the Mycosan nail kit in patients with onychomycosis who had contraindications to systemic therapy helped to reduce brittleness, turbidity, and striation at the 4th week of treatment in 40 (25.9 %) patients. At the 8th week of treatment, a decrease in the listed symptoms was observed in 52 (33.8 %) persons, an improvement in the marginal zone — in 85 (55.2 %) persons. A decrease in brittleness, turbidity, striation and density at the 16th week was noted in 148 (96.8 %) patients. The marginal zone became normal in 152 (98.7 %) patients. Hyperkeratotic compactions were absent in 103 (66.9 %) patients. At the 24th week, the state of clinical remission was observed in 52 (33.8 %) patients, significant improvement — in 45 (29.2 %), improvement — in 35 (22.7 %) patients.Mycological negativity at the 4th week was achieved in 20 (13.0 %), at the 8th week — in 33 (21.4 %), at the 16th week — in 52 (33.8 %), at the 24th week — in 82 (53.2 %) patients.According to the analysis of questionnaires on the general assessment of consumer qualities of Mycosan nail kit, it was found that its organoleptic characteristics were rated as «very good» by 39 (25.3%) patients, and «good» — by 115 (74.7%) patients.Conclusions. Mycosan nail kit has a pronounced clinical and mycological effectiveness in eliminating fungal lesions of the nail plates. The drug is well tolerated, does not cause any undesirable manifestations, and contributes to the formation of adherence to therapy in the vast majority of patients. Mycosan is recommended for patients with onychomycosis with a mild degree of damage, in the complex treatment of patients with a more severe degree of damage, in the presence of absolute or relative contraindications to treatment with systemic antifungal drugs, as well as for improvement of the structure of the nail plates and prevention of further destruction of the nails.