Onychomycosis is a public health concern because of its high world wide prevalence and its potential for spread of fungal elements to others. About one half of all patients presenting to dermatologists' offices for nail disorders have onychomycosis. This kind of infection may impact upon physical, functional and emotional aspects of life. Onychomycosis can be treated with the new generation of oral antifungals. Efficacy rates for fingernail onychomycosis are high; however, for toenail onychomycosis, efficacy rates may range from 60% to 80%. Relapse rates have been estimated to be 15% to 20% measured at 2 years following therapy initiation. Because many factors may be associated with a suboptimal clinical response, consideration to measures that retlect the most appropriate pharmacologic and supportive regimens must be made in order to meet the challenge of onychomycosis cure. In some situations supplemcntal therapy consisting of extra antifungal or adjunctive (topical/surgical) therapy may be beneficial.
Nail plate susceptibility 10 Scopulariopsis brevicaulis infection. Experimental Scopulariopsis brevicaulis infection of toe and finger nails collected from 79 persons of both sexes and at various age is presented. Crumbled nail fragments were incubated with a S. brevicaulis strain isolated from toenail acauliosis. The culture was inspected and evaluated under light microscope after seven days of incubalion. Hyphe intensively penetrating nail fragments were found in 67.1% of toenails and 38% of fingernails. The infection was most intensive in the nails collected from males and elderly persons.
The aim of the study was to present the own observations concerning treatment of patients above 50 years of age suffering the toe nail dermatophyte onychomycosis with intensified subungual keratosis and considerable nail plates destruction. Three different treatment methods were administered: 40 patients were treated only with itraconazole pulse method for 3 month, 35 patients besides itraconazole were given also pentoxifylline. In case of 20 individuals besides 3-month itraconazole pulse method treatment, the amorolfine varnish application onto changed nails once a week for 6 month was administered. In the group of patients treated only with itraconazole, in 22 cases (55,0%) the cure was obtained, while in the group of individuals given the combined therapy with pentoxifylline, the cures made 71.4% (25 individuals). From among patients treated with itraconazole and external amoroltine application the cures made 75,0% (15 individuals).