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2008, Number 3

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Dermatología Cosmética, Médica y Quirúrgica 2008; 6 (3)

Onychomycosis. Evaluation of the combined surgical, oral and topical treatments

Carbajosa MJ, Arenas R

Language: Spanish
References: 44
Page: 157-162
PDF size: 231.53 Kb.


ABSTRACT

Background: Onychomycoses is a frequent dermatological disease. The usual oral and topical treatment can be improved by a surgical curettage.
Objective: To evaluate the oral and topical treatment plus surgical management in onychomycosis.
Material and methods: We report an open and observational study in the treatment of onychomycosis from 1994 to 2001. In all patients a mycological study was performed and the cases were divided in two groups, one with negative and the other one with a positive KOH exam. This last group received either the conventional treatment (topical, oral or both) or the triple treatment (oral, topical and surgical curettage). Patients were evaluated at 2, 4, 6, 12 months, and a follow up during 2 to 3 years. We consider cures, failures or recurrences just from the clinical aspect.
Results: 99 patients with the clinical diagnosis of onychomycosis, 51 of them had a positive KOH and 37 received the triple treatment. The most frequent causal agents were T. Rubrum (73%) and Candida sp (8%). T. Mentagrophytes was isolated in 2 cases and Fusarium sp in one. The group with the triple treatment had a cure rate of 71%, and those with the conventional treatment 36% (P=0.1). The group with ungueal dystrophy and negative KOH had a cure rate of 20.8% (P=0.000).
Conclusions: Surgical treatment is proposed as an adyuvant in onychomycosis. It is an effective procedure to obtain higher rates of success.


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