Clinical comparison and complete cure rates of terbinafine efficacy in affected onychomycotic toenails. (30th July 2014)

• Record Type: Journal Article
• Authors: Shemer, A.; Sakka, N.; Baran, R.; Scher, R.; Amichai, B.; Norman, L.; Farhi, R.; Magun, R.; Brazilai, A.; Daniel, R.
• Is Part Of: Journal of the European Academy of Dermatology and Venereology. Volume 29:Number 3(2015:Mar.)
• Page Start: 521
• Page End: 526
• Publication Date: 2014-07-30
• Subjects: Dermatology -- Periodicals; Sexually transmitted diseases -- Periodicals; 616.5
• DOI: 10.1111/jdv.12609
• Languages: English
• ISSNs: 0926-9959

Abstract

<abstract abstract-type="main" id="jdv12609-abs-0001"> <title>Abstract</title> <sec id="jdv12609-sec-0001" sec-type="section"> <title>Background</title> <p>Clinical studies regarding complete cure rate of onychomycosis using oral Terbinafine have a very broad range (14–90%) based solely on response to treatment on the big toenail.</p> </sec> <sec id="jdv12609-sec-0002" sec-type="section"> <title>Objective</title> <p>To evaluate the efficacy of Terbinafine in all affected onychomycotic toenails and, furthermore, to evaluate differences in mycological, clinical and complete cure rate between affected onychomycotic toenails.</p> </sec> <sec id="jdv12609-sec-0003" sec-type="section"> <title>Patients and methods</title> <p>Inclusion criteria are as follows: distolateralsubungual onychomycotic involvement of the hallux and additional involvement of at least two more toenails of the same foot. Exclusion criteria are as follows: patients with nail traumata and hypersensitivity to Terbinafine. Patients were treated with oral Terbinafine 250 mg/day for 16 weeks. Mycological analysis was performed using direct microscopy and culture. Clinical improvement was assessed using digital photography.</p> </sec> <sec id="jdv12609-sec-0004" sec-type="section"> <title>Results</title> <p>Statistically significant difference was found in clinical improvement between the great toenail and all other involved toenails. The rate of complete cure (100% clinical cure and mycological cure) of the big toenail was lower (23%) as compared to the second (65%), third (51%) and the fourth toenail (67%).</p> </sec> <sec id="jdv12609-sec-0005" sec-type="section"> <title>Limitations</title> <p>This is a case series study that was based on a single‐centre cohort.</p> </sec> <sec id="jdv12609-sec-0006" sec-type="section"> <title>Conclusions</title> <p>Our results support findings that efficacy of Terbinafine should be based on all involved onychomycotic toenails; the big toenail is not superior in response compared to other affected toenails.</p> </sec> </abstract>