Factors influencing cure rates of non‐dermatophyte mold and Candida onychomycosis: analysis of outcomes in 81 patients who completed treatment

Objectives Onychomycosis shows a poor response to current topical, oral, or device‐related antifungal therapies. The aim of this study was to identify factors influencing the cure rates of non‐dermatophyte mold and Candida onychomycosis. Methods Eighty‐one patients who completed treatments were divi...

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Veröffentlicht in:International journal of dermatology 2017-02, Vol.56 (2), p.202-208
Hauptverfasser: Ranawaka, Ranthilaka R., Silva, S. H. Padmal
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Silva, S. H. Padmal
description Objectives Onychomycosis shows a poor response to current topical, oral, or device‐related antifungal therapies. The aim of this study was to identify factors influencing the cure rates of non‐dermatophyte mold and Candida onychomycosis. Methods Eighty‐one patients who completed treatments were divided into “cured” and “non‐cured” groups. The statistical significance of differences between the two groups was studied. Results Male gender (P < 0.01), long duration of disease before the initiation of treatment (P < 0.02), three or more infected nails (P < 0.0002), continuous exposure to water and detergents (P < 0.05), frequent exposure to mud and soil (P < 0.01), barefoot walking (P < 0.025), concomitant diabetes and hypertension (P < 0.04), eczema (P < 0.03), and associated paronychia (P < 0.01) had negative effects on cure rates of onychomycosis. Patient age, occupation, site of illness (hand, foot or big toe), type of disease (distal and lateral subungual onychomycosis, proximal subungual onychomycosis or total dystrophic onychomycosis), pathogenic fungi, and treatment modality had no statistically significant impact on cure rate. Conclusions To minimize the failure rate of antifungal therapies in the treatment of onychomycosis, patients are advised to start treatment as soon as possible, and to avoid predisposing factors such as exposure to water, detergents, mud and soil, and barefoot walking.
doi_str_mv 10.1111/ijd.13426
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H. Padmal</creator><creatorcontrib>Ranawaka, Ranthilaka R. ; Silva, S. H. Padmal</creatorcontrib><description><![CDATA[Objectives Onychomycosis shows a poor response to current topical, oral, or device‐related antifungal therapies. The aim of this study was to identify factors influencing the cure rates of non‐dermatophyte mold and Candida onychomycosis. Methods Eighty‐one patients who completed treatments were divided into “cured” and “non‐cured” groups. The statistical significance of differences between the two groups was studied. Results Male gender (P < 0.01), long duration of disease before the initiation of treatment (P < 0.02), three or more infected nails (P < 0.0002), continuous exposure to water and detergents (P < 0.05), frequent exposure to mud and soil (P < 0.01), barefoot walking (P < 0.025), concomitant diabetes and hypertension (P < 0.04), eczema (P < 0.03), and associated paronychia (P < 0.01) had negative effects on cure rates of onychomycosis. Patient age, occupation, site of illness (hand, foot or big toe), type of disease (distal and lateral subungual onychomycosis, proximal subungual onychomycosis or total dystrophic onychomycosis), pathogenic fungi, and treatment modality had no statistically significant impact on cure rate. Conclusions To minimize the failure rate of antifungal therapies in the treatment of onychomycosis, patients are advised to start treatment as soon as possible, and to avoid predisposing factors such as exposure to water, detergents, mud and soil, and barefoot walking.]]></description><identifier>ISSN: 0011-9059</identifier><identifier>EISSN: 1365-4632</identifier><identifier>DOI: 10.1111/ijd.13426</identifier><identifier>PMID: 27813064</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Antifungal Agents - therapeutic use ; Aspergillosis - complications ; Aspergillosis - drug therapy ; Candida ; Candidiasis - complications ; Candidiasis - drug therapy ; Candidiasis - microbiology ; Detergents ; Diabetes Complications - complications ; Diabetes mellitus ; Eczema ; Eczema - complications ; Exposure ; Feet ; Female ; Foot Dermatoses - drug therapy ; Foot Dermatoses - microbiology ; Fungi ; Fungicides ; Fusariosis - complications ; Fusariosis - drug therapy ; Hand Dermatoses - drug therapy ; Hand Dermatoses - microbiology ; Humans ; Hypertension ; Hypertension - complications ; Itraconazole - therapeutic use ; Male ; Middle Aged ; Mud ; Nails (Anatomy) ; Naphthalenes - therapeutic use ; Onychomycosis ; Onychomycosis - drug therapy ; Onychomycosis - microbiology ; Paronychia ; Paronychia - complications ; Patients ; Risk Factors ; Skin diseases ; Soil ; Soil water ; Soils ; Statistical analysis ; Statistical significance ; Time-to-Treatment ; Toe ; Treatment Outcome ; Walking ; Water ; Young Adult</subject><ispartof>International journal of dermatology, 2017-02, Vol.56 (2), p.202-208</ispartof><rights>2016</rights><rights>2016 The International Society of Dermatology.</rights><rights>International Journal of Dermatology © 2017 International Society of Dermatology</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3466-998a8f4ae9af43d436dad4093e93a6d75934b78e15ac4604e57fed12ad9452cb3</cites><orcidid>0000-0002-2416-3547</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fijd.13426$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fijd.13426$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27923,27924,45573,45574</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27813064$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ranawaka, Ranthilaka R.</creatorcontrib><creatorcontrib>Silva, S. H. Padmal</creatorcontrib><title>Factors influencing cure rates of non‐dermatophyte mold and Candida onychomycosis: analysis of outcomes in 81 patients who completed treatment</title><title>International journal of dermatology</title><addtitle>Int J Dermatol</addtitle><description><![CDATA[Objectives Onychomycosis shows a poor response to current topical, oral, or device‐related antifungal therapies. The aim of this study was to identify factors influencing the cure rates of non‐dermatophyte mold and Candida onychomycosis. Methods Eighty‐one patients who completed treatments were divided into “cured” and “non‐cured” groups. The statistical significance of differences between the two groups was studied. Results Male gender (P < 0.01), long duration of disease before the initiation of treatment (P < 0.02), three or more infected nails (P < 0.0002), continuous exposure to water and detergents (P < 0.05), frequent exposure to mud and soil (P < 0.01), barefoot walking (P < 0.025), concomitant diabetes and hypertension (P < 0.04), eczema (P < 0.03), and associated paronychia (P < 0.01) had negative effects on cure rates of onychomycosis. Patient age, occupation, site of illness (hand, foot or big toe), type of disease (distal and lateral subungual onychomycosis, proximal subungual onychomycosis or total dystrophic onychomycosis), pathogenic fungi, and treatment modality had no statistically significant impact on cure rate. Conclusions To minimize the failure rate of antifungal therapies in the treatment of onychomycosis, patients are advised to start treatment as soon as possible, and to avoid predisposing factors such as exposure to water, detergents, mud and soil, and barefoot walking.]]></description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antifungal Agents - therapeutic use</subject><subject>Aspergillosis - complications</subject><subject>Aspergillosis - drug therapy</subject><subject>Candida</subject><subject>Candidiasis - complications</subject><subject>Candidiasis - drug therapy</subject><subject>Candidiasis - microbiology</subject><subject>Detergents</subject><subject>Diabetes Complications - complications</subject><subject>Diabetes mellitus</subject><subject>Eczema</subject><subject>Eczema - complications</subject><subject>Exposure</subject><subject>Feet</subject><subject>Female</subject><subject>Foot Dermatoses - drug therapy</subject><subject>Foot Dermatoses - microbiology</subject><subject>Fungi</subject><subject>Fungicides</subject><subject>Fusariosis - complications</subject><subject>Fusariosis - drug therapy</subject><subject>Hand Dermatoses - drug therapy</subject><subject>Hand Dermatoses - microbiology</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertension - complications</subject><subject>Itraconazole - therapeutic use</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mud</subject><subject>Nails (Anatomy)</subject><subject>Naphthalenes - therapeutic use</subject><subject>Onychomycosis</subject><subject>Onychomycosis - drug therapy</subject><subject>Onychomycosis - microbiology</subject><subject>Paronychia</subject><subject>Paronychia - complications</subject><subject>Patients</subject><subject>Risk Factors</subject><subject>Skin diseases</subject><subject>Soil</subject><subject>Soil water</subject><subject>Soils</subject><subject>Statistical analysis</subject><subject>Statistical significance</subject><subject>Time-to-Treatment</subject><subject>Toe</subject><subject>Treatment Outcome</subject><subject>Walking</subject><subject>Water</subject><subject>Young Adult</subject><issn>0011-9059</issn><issn>1365-4632</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkc1u1DAUhS1ERaeFBS-ALLGhi7T-ixOzq6YtFFViA-vIY98wHiV2sB1V2fEIfUaeBA9TWFRC4i58r3W-eyz5IPSaknNa6sLt7DnlgslnaEW5rCshOXuOVoRQWilSq2N0ktKuXDmj4gU6Zk1LOZFihR5utMkhJux8P8zgjfPfsJkj4KgzJBx67IP_-ePBQhx1DtN2yYDHMFisvcXrcjircfCL2YZxMSG59L5IeljKtF8PczZhhP0LuKV40tmBzwnfbwMuwjRABotzBJ3HIrxER70eErx67Kfo6831l_XH6u7zh9v15V1luJCyUqrVbS80KN0LbgWXVltBFAfFtbRNrbjYNC3QWhshiYC66cFSpq0SNTMbforeHXynGL7PkHI3umRgGLSHMKeOtrLltCE1-w-Uy4Y1jSAFffsE3YU5lt8olGJEtIwxWaizA2ViSClC303RjTouHSXdPtGuJNr9TrSwbx4d580I9i_5J8ICXByAezfA8m-n7vbT1cHyFx-hrLE</recordid><startdate>201702</startdate><enddate>201702</enddate><creator>Ranawaka, Ranthilaka R.</creator><creator>Silva, S. H. Padmal</creator><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7U7</scope><scope>C1K</scope><scope>H94</scope><scope>7X8</scope><scope>M7N</scope><orcidid>https://orcid.org/0000-0002-2416-3547</orcidid></search><sort><creationdate>201702</creationdate><title>Factors influencing cure rates of non‐dermatophyte mold and Candida onychomycosis: analysis of outcomes in 81 patients who completed treatment</title><author>Ranawaka, Ranthilaka R. ; Silva, S. H. Padmal</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3466-998a8f4ae9af43d436dad4093e93a6d75934b78e15ac4604e57fed12ad9452cb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antifungal Agents - therapeutic use</topic><topic>Aspergillosis - complications</topic><topic>Aspergillosis - drug therapy</topic><topic>Candida</topic><topic>Candidiasis - complications</topic><topic>Candidiasis - drug therapy</topic><topic>Candidiasis - microbiology</topic><topic>Detergents</topic><topic>Diabetes Complications - complications</topic><topic>Diabetes mellitus</topic><topic>Eczema</topic><topic>Eczema - complications</topic><topic>Exposure</topic><topic>Feet</topic><topic>Female</topic><topic>Foot Dermatoses - drug therapy</topic><topic>Foot Dermatoses - microbiology</topic><topic>Fungi</topic><topic>Fungicides</topic><topic>Fusariosis - complications</topic><topic>Fusariosis - drug therapy</topic><topic>Hand Dermatoses - drug therapy</topic><topic>Hand Dermatoses - microbiology</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Hypertension - complications</topic><topic>Itraconazole - therapeutic use</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mud</topic><topic>Nails (Anatomy)</topic><topic>Naphthalenes - therapeutic use</topic><topic>Onychomycosis</topic><topic>Onychomycosis - drug therapy</topic><topic>Onychomycosis - microbiology</topic><topic>Paronychia</topic><topic>Paronychia - complications</topic><topic>Patients</topic><topic>Risk Factors</topic><topic>Skin diseases</topic><topic>Soil</topic><topic>Soil water</topic><topic>Soils</topic><topic>Statistical analysis</topic><topic>Statistical significance</topic><topic>Time-to-Treatment</topic><topic>Toe</topic><topic>Treatment Outcome</topic><topic>Walking</topic><topic>Water</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ranawaka, Ranthilaka R.</creatorcontrib><creatorcontrib>Silva, S. H. Padmal</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><jtitle>International journal of dermatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ranawaka, Ranthilaka R.</au><au>Silva, S. H. Padmal</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Factors influencing cure rates of non‐dermatophyte mold and Candida onychomycosis: analysis of outcomes in 81 patients who completed treatment</atitle><jtitle>International journal of dermatology</jtitle><addtitle>Int J Dermatol</addtitle><date>2017-02</date><risdate>2017</risdate><volume>56</volume><issue>2</issue><spage>202</spage><epage>208</epage><pages>202-208</pages><issn>0011-9059</issn><eissn>1365-4632</eissn><abstract><![CDATA[Objectives Onychomycosis shows a poor response to current topical, oral, or device‐related antifungal therapies. The aim of this study was to identify factors influencing the cure rates of non‐dermatophyte mold and Candida onychomycosis. Methods Eighty‐one patients who completed treatments were divided into “cured” and “non‐cured” groups. The statistical significance of differences between the two groups was studied. Results Male gender (P < 0.01), long duration of disease before the initiation of treatment (P < 0.02), three or more infected nails (P < 0.0002), continuous exposure to water and detergents (P < 0.05), frequent exposure to mud and soil (P < 0.01), barefoot walking (P < 0.025), concomitant diabetes and hypertension (P < 0.04), eczema (P < 0.03), and associated paronychia (P < 0.01) had negative effects on cure rates of onychomycosis. Patient age, occupation, site of illness (hand, foot or big toe), type of disease (distal and lateral subungual onychomycosis, proximal subungual onychomycosis or total dystrophic onychomycosis), pathogenic fungi, and treatment modality had no statistically significant impact on cure rate. Conclusions To minimize the failure rate of antifungal therapies in the treatment of onychomycosis, patients are advised to start treatment as soon as possible, and to avoid predisposing factors such as exposure to water, detergents, mud and soil, and barefoot walking.]]></abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>27813064</pmid><doi>10.1111/ijd.13426</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-2416-3547</orcidid></addata></record>
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subjects Adult
Aged
Aged, 80 and over
Antifungal Agents - therapeutic use
Aspergillosis - complications
Aspergillosis - drug therapy
Candida
Candidiasis - complications
Candidiasis - drug therapy
Candidiasis - microbiology
Detergents
Diabetes Complications - complications
Diabetes mellitus
Eczema
Eczema - complications
Exposure
Feet
Female
Foot Dermatoses - drug therapy
Foot Dermatoses - microbiology
Fungi
Fungicides
Fusariosis - complications
Fusariosis - drug therapy
Hand Dermatoses - drug therapy
Hand Dermatoses - microbiology
Humans
Hypertension
Hypertension - complications
Itraconazole - therapeutic use
Male
Middle Aged
Mud
Nails (Anatomy)
Naphthalenes - therapeutic use
Onychomycosis
Onychomycosis - drug therapy
Onychomycosis - microbiology
Paronychia
Paronychia - complications
Patients
Risk Factors
Skin diseases
Soil
Soil water
Soils
Statistical analysis
Statistical significance
Time-to-Treatment
Toe
Treatment Outcome
Walking
Water
Young Adult
title Factors influencing cure rates of non‐dermatophyte mold and Candida onychomycosis: analysis of outcomes in 81 patients who completed treatment
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