Terbinafine for the treatment of pedal onychomycosis. A foot closer to the promised land of cured nails?

Abstract

Onychomycosis of the nails includes fungal infection caused by primary nail pathogens that invade the healthy nail plate and secondary invasion in nails with preexisting disease.¹Onychomycosis may be due to secondary infection from tinea pedis and is the most common nail disease, accounting for roughly 30% of all cutaneous fungal infections.²In a survey of 9332 British adults, 16 years of age and older, the prevalence of dermatophyte infection was 2.6% to 2.8%.³In subjects 55 years of age or older, the prevalence was 4.7%. In the United States, a similar prevalence has been reported.⁴Onychomycosis can have a significant psychological effect on the subject.⁵In a North American study, the relative composition of isolates from nails was dermatophytes (91%), yeasts (5%), and molds (4%).⁶Candida is isolated predominantly from fingernails.⁷Uncommonly, there are mixed infections. In other parts of the world,