Efficacy and tolerability of amorolfine 5% nail lacquer in combination with systemic antifungal agents for onychomycosis: A meta-analysis and systematic review
The efficacy and safety of amorolfine 5% nail lacquer in combination with systemic antifungal agents in the treatment of the onychomycosis were evaluated. According to our meta-analysis, combination treatment of amorolfine 5% nail lacquer and systemic antifungals can result in higher percentage of complete clearance of onychomycosis.
The objective of this study was to investigate patient-reported outcomes (treatment utilisation, adherence and satisfaction) in onychomycosis treated with once-weeklyamorolfine 5% nail lacquer versus once-daily ciclopirox 8% nail lacquer (Study A) or once-daily urea 40% ointment/bifonazole 1% cream combination regimen (Study B). Study A: Subjects receivedamorolfine and ciclopirox on opposite feet for 12 weeks.
AAPS PharmSciTech. 2017 Mar 13. doi: 10.1208/s12249-017-0752-y.Kushwaha AS, Sharma P, Shivakumar HN, Rappleye C, Zukiwski A, Proniuk S, Murthy SN.AR-12 is a novel small molecule with broad spectrum antifungal activity. Recently, AR-12 was found to be highly active against Trichophyton rubrum, one of the predominantly responsible organisms that cause onychomycosis.
CONCLUSIONS: The most frequent isolated etiological agent for toenails was Trichophyton Rubrum, for fingernails was Candida Albicans. PMID: 28594608 [PubMed - as supplied by publisher]
In conclusion, molecular techniques were useful but showed limitations. The panfungal assay showed a low sensitivity, the pandermatophyte assay was sensitive and specific but did not allow for differentiation among species of dermatophytes. Finally, the role of non‐dermatophyte species detected by using specific RT‐PCR techniques should be carefully analysed as these species were also present in healthy nails.
Publication date: Available online 22 April 2017 Source:Actas Dermo-Sifiliográficas (English Edition) Author(s): M. Álvarez-Salafranca, S. Hernández-Ostiz, S. Salvo Gonzalo, M. Ara Martín
Conclusions Yeasts were the main causal agents followed by non-dermatophytic fungi (mainly species of Aspergillus, then Alternaria, Scopulariopsis and Fusarium). Both direct microscopic preparations and culturing are recommended for mycological evaluation of clinical specimens. Sequence analysis of ITS region is recommended for yeast identification.
a Martín M PMID: 28012546 [PubMed - as supplied by publisher]
Authors: Serini SM, Veraldi S PMID: 27348329 [PubMed - as supplied by publisher]
Authors: Noguchi H, Hiruma M, Miyashita A, Makino K, Miyata K, Ihn H Abstract A 56-year-old woman on insulin therapy for diabetes visited our clinic due to whitish discoloration on the right index finger. Despite topical application of 1% lanoconazole solution, the lesion grew, causing paronychia. Direct microscopy revealed non-dermatophyte molds. Based on the morphological features and genetic analysis of the isolate, the pathogen was identified as Aspergillus flavus. The patient was diagnosed with proximal subungual onychomycosis due to A. flavus. Following itraconazole pulse therapy, she was cured in 6 months. T...
An interprofessional approach to treatment of patients with onychomycosis may be particularly valuable because of patient comorbidities and recurrent infection. Good communication between the different members of the team that includes the primary care physician, dermatologist, and nurse practitioner is essential. The activity presented here illustrates how the interprofessional approach can work in this setting.