Topical therapy of onychomycosis in patients with psoriasis

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.