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J Cutan Med Surg. 2015 May-Jun;19(3):260-73. doi: 10.2310/7750.2014.14090. Epub 2015 Mar 13.

Management of Onychomycosis in Canada in 2014.

Author information

1
Department of Medicine, University of Toronto, Toronto, ON, and Mediprobe Research Inc., London, ON agupta@execulink.com.
2
Department of Medicine, University of Toronto, Toronto, ON, and Mediprobe Research Inc., London, ON.

Abstract

BACKGROUND:

Onychomycosis has several clinical presentations and is caused by various infectious organisms.

OBJECTIVE:

To provide guidance for selection of appropriate treatment.

METHODS:

The literature on onychomycosis management was reviewed to generate an evidence-based decision tree.

RESULTS AND CONCLUSION:

Several options are available: terbinafine, itraconazole, fluconazole, ciclopirox 8% nail lacquer, efinaconazole 10% nail solution, and laser therapy. Further studies on lasers are needed before use can be recommended. Nondermatophyte molds or mixed infection can be managed with terbinafine or itraconazole with or without topicals. Itraconazole, fluconazole, and efinaconazole can be used for Candida infection. For dermatophytes, topicals can be considered for mild to moderate onychomycosis. For moderate to severe cases, any oral monotherapy can be used; however, we suggest terbinafine if there is a possibility of a drug interaction. These recommendations can be applied for all ages, immune function, or metabolic status, but proper monitoring and contraindications should be taken into consideration.

PMID:
25775640
DOI:
10.2310/7750.2014.14090
[Indexed for MEDLINE]

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