Subject(s)
Itraconazole/therapeutic use , Microsporum , Onychomycosis/drug therapy , Adult , Female , Humans , Onychomycosis/microbiologyABSTRACT
We have treated 48 cases of onychomycosis (of which 37 were caused by dermatophytes, 10 by yeasts and one by Scopulariopsis brevicaulis) with 200 mg ketoconazole daily. We obtained recovery in 65 p. 100 of the cases of onyxis caused by dermatophytes and in 80 p. 100 of the cases of onychomycosis due to Candida. The one patient presenting an infection with Scopulariopsis brevicaulis recovered in 13 months. The average duration necessary to obtain complete recovery was 6 1/2 months for onychomycosis of the hands due to dermatophytes and 12 1/2 months for those of the feet. Perionyxis due to Candida needed 2 months of treatment with this drug, however 6 months of treatment were necessary to obtain recovery for onycholysis due to Candida. Biological tests remained normal and the side-effects were minimal and essentially gastrointestinal in our study. Ketoconazole is an effective treatment for onychomycosis: it is active against the different mycotic agents infecting nails and well tolerated by the patient. Several minor effects such as itching, nausea, headache and more serious reactions such as erythrodermia and hepatitis have been reported. Regular control and biological tests are therefore necessary. Patients with other diseases should avoid the use of ketoconazole for treatment of onychomycosis.
Subject(s)
Ketoconazole/therapeutic use , Onychomycosis/drug therapy , Adolescent , Adult , Aged , Arthrodermataceae , Candidiasis/drug therapy , Female , Foot Dermatoses/drug therapy , Hand Dermatoses/drug therapy , Humans , Ketoconazole/adverse effects , Male , Middle AgedABSTRACT
The authors studied in vitro and in vivo the invasion of the nail keratin by saprophytes. This invasion takes palce in the same way in both cases: mycelian filaments and spores penetrate in the hyponychium, filaments penetrate in the upper part of the tablet, filaments and, as far as some saprophytes are concerned, 'boring hyphae' penetrate in the lower part of the tablet. Those ways of invasion are responsible for the clinical pictures (onychomycosis, pachyonychia, leuconychomycosis). Electron microscopically the mycelian filaments appear to be both intercellular and intracellular. The authors insist in the importance of the criteria of evaluation which allow us to establish the saprophytic origin of onychomycosis.
