Topical therapy of onychomycosis in patients with psoriasis

K. Suprun, I.O. Oliynyk
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Abstract

Objective — to study the effectiveness of the method of treating onychomycosis using only local agents in patients suffering from psoriasis and having contraindications to the use of systemic antifungal agents. Materials and methods. The study involved 52 patients with psoriasis and lesions of the nail plates, aged 21 to 67 years. The duration of the disease was from 1 to 27 years.To verify the fungal infection of the nail plates, a microscopic examination of nail scales with 20 % KOH and molecular genetic studies using pan-fungal primers were carried out.Among 52 examined patients with psoriasis who had clinical signs of lesions of the nail plates, there were 37 people with mycotic infection lesions of the nail plates.Due to the somatic burden, the use of systemic antifungal agents was contraindicated. Treatment of onychomycosis in such patients was carried out using only local therapy and sanitary-hygienic measures. As a topical antifungal therapy, 1 % solution and 1 % cream of naftifine hydrochloride were prescribed in combination with drugs that improve the structure of the nail plates (Volvit, 5 mg once a day and Cytoflavin, 2 tablets 2 times a day for 1.5 months). Results and discussion. 1 month after the beginning of the use of the proposed method for the treatment of nail fungal infection in case of psoriasis of the scales of the nail plates, mycelium and fungal spores were absent in 6 (16.2 %) patients with distal lesions of the nail plates. After 4 months of treatment they were absent in 16 (43.4 %) patients with distal-lateral lesions of the nail plates, after 6 months — in 21 (56.7 %) patients, after 9 months — in 26 (70.2 %) patients. Conclusions. The proposed complex method is quite effective and of higher priority for the treatment of onychomycosis in patients with comorbid conditions that make it impossible to treat a fungal infection with systemic antimycotics.
银屑病患者甲真菌病的局部治疗
目的:探讨银屑病患者局部用药治疗甲真菌病的疗效,并对全身使用抗真菌药物有禁忌症。材料和方法。该研究涉及52名患有牛皮癣和甲板病变的患者,年龄在21至67岁之间。病程1 ~ 27年。为了验证甲板真菌感染,用20% KOH对甲鳞片进行显微镜检查,并使用泛真菌引物进行分子遗传学研究。52例有甲板病变临床体征的银屑病患者中,有37例甲板真菌感染病变。由于躯体负担,使用全身抗真菌药物是禁忌的。对这类患者的甲真菌病的治疗仅采用局部治疗和卫生措施。作为局部抗真菌治疗,处方盐酸纳替芬1%溶液和1%乳膏联合改善甲板结构的药物(Volvit, 5 mg, 1次/天,Cytoflavin, 2片,2次/天,持续1.5个月)。结果和讨论。采用本方法治疗甲鳞银屑病甲真菌感染1个月后,6例(16.2%)甲远端病变患者无菌丝体和真菌孢子。治疗4个月后,16例(43.4%)患远侧甲板病变的患者无骨,6个月后21例(56.7%),9个月后26例(70.2%)。结论。所提出的复杂方法是相当有效的,并具有更高的优先级的治疗甲癣患者的合并症的条件,使得它不可能治疗真菌感染与全身抗真菌药物。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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