Treatment failures and relapses in onychomycosis: a stubborn clinical problem.

Administration, Oral; Administration, Topical; Antifungal Agents/administration & dosage; Biopsy, Needle; Controlled Clinical Trials as Topic; Female; Foot Dermatoses; Hand Dermatoses; Humans; Immunohistochemistry; Male; Onychomycosis/diagnosis/drug therapy/pathology; Prognosis; Recurrence; Risk Assessment; Severity of Illness Index; Treatment Failure

Abstract :

[en] The therapeutic outcome of onychomycoses is uncertain. Comparative short-term efficacy studies on antifungals abound and report contradictory findings. Few unbiased follow-up studies have scrutinized the long-term outcome. Basically, none of the current antifungals can guarantee cure in all instances. In addition, relapses are not rare. The causes of therapeutic failure in onychomycoses are multiple. The most important are the lack of diagnostic accuracy, inadequate antifungal choice or delivery modality, and presence of dormant conidia, sequestrated mycelium pockets or resistant fungal species. The concept of fungicidal drug derived from selected in vitro studies appears irrelevant in clinical practice.

Disciplines :

Dermatology

Author, co-author :

Arrese Estrada, Jorge ; Centre Hospitalier Universitaire de Liège - CHU > Dermatopathologie

Pierard, Gérald ; Centre Hospitalier Universitaire de Liège - CHU > Dermatopathologie

Language :

English

Title :

Treatment failures and relapses in onychomycosis: a stubborn clinical problem.

Publication date :

2003

Journal title :

Dermatology

ISSN :

1018-8665

eISSN :

1421-9832

Publisher :

S. Karger, Basel, Switzerland

Volume :

207

Issue :

Pages :

255-60

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 12 March 2009

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Bibliography

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