Onicomicosis: afección común de difícil tratamiento
DOI:
https://doi.org/10.29176/2590843X.224Palabras clave:
onicomicosis, enfermedades de la uña, hongosResumen
La onicomicosis es la enfermedad más frecuente de las uñas. Es una infección de la unidad ungular causada por dermatofitos, mohos y levaduras, de los cuales, los primeros son los agentes causales más frecuentes a nivel mundial. Sin embargo, la epidemiología puede variar de acuerdo con la ubicación geográfica y el clima. En el presente manuscrito se presenta una revisión de la literatura científica sobre la epidemiología, las presentaciones clínicas, el diagnóstico y el tratamiento de las onicomicosis.
Biografía del autor/a
Natalia Mendoza
Médica, residente de dermatología; Universidad Pontificia Bolivariana, Medellín, Colombia
Claudia Palacios
Médica, residente de dermatología; Universidad Pontificia Bolivariana, Medellín, Colombia
Nora Cardona
Médica, M.Sc., Investigadora y profesora asociada, Universidad CES; Instituto Colombiano de Medicina Tropical, Medellín, Colombia
Luz Marina Gómez
Médica dermatóloga; profesora titular de Dermatología, Universidad Pontificia Bolivariana, Medellín, Colombia
Referencias bibliográficas
1. Kaur R, Kashyap B, Bhalla P. Onychomycosis –epidemiology, diagnosis and management. Indian J Med Microbiol. 2008;26:108-16.
2. Welsh O, Vera-Cabrera L, Welsh E. Onychomycosis. Clin Dermatol. 2010;28:151-9.
3. Scher RK. Onychomycosis: A significant medical disorder. J Am Acad Dermatol. 1996;35:S2-5.
4. Effendy I, Lecha M, Feuilhade M, Di Chiacchio N, Baran R. Epidemiology and clinical classification of onychomycosis. J Eur Acad Dermatol Venereol. 2005;19 (Suppl.1):8-12.
5. Rodríguez-Pazos L, Pereiro-Ferreirós MM, Pereiro M Jr, Toribio J. Onychomycosis observed in children over a 20-year period. Mycoses. 2011;54:450-3.
6. Manzano-Gayosso P, Méndez-Tovar LJ, Arenas R, HernándezHernández F, Millán-Chiu B, Torres-Rodríguez JM, et al. Onychomycosis-causing yeasts in four Mexican dermatology centers and their antifungal susceptibility to azolic compounds. Rev Iberoam Micol. 2011;28:32-5.
7. Ghannoum MA, Hajjeh RA, Scher R, Konnikov N, Gupta AK, Summerbell R, et al. A large-scale North American study of fungal isolates from nails: The frequency of onychomycosis, fungal distribution, and antifungal susceptibility patterns. J Am Acad Dermatol. 2000;43:641-8.
8. Vender RB, Lynde CW, Poulin Y. Prevalence and epidemiology of onychomycosis. J Cutan Med Surg. 2006;10(Suppl.2):S28-33.
9. Tosti A, Hay R, Arenas-Guzmán R. Patients at risk of onychomycosis –risk factor identification and active prevention. J Eur Acad Dermatol Venereol. 2005;19(Suppl.1):13-6.
10. Zaias N, Tosti A, Rebell G, Morelli R, Bardazzi F, Bieley H, et al. Autosomal dominant pattern of distal subungual onychomycosis caused by Trichophyton rubrum. J Am Acad Dermatol. 1996;34:302-4.
11. Zaitz C, Campbell I, Moraes JR, Moraes ME, Gouvea C, Romero M, et al. HLA-associated susceptibility to chronic onychomycosis in Brazilian Ashkenazic Jews. Int J Dermatol. 1996;35:681-2.
12. García-Romero MT, Granados J, Vega-Memije ME, Arenas R. Analysis of genetic polymorphism of the HLA-B and HLA-DR loci in patients with dermatophytic onychomycosis and in their firstdegree relatives. Actas Dermo-Sifiliogr. 2011. Fecha de consulta: 29 de septiembre de 2011. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/21742300
13. Asz-Sigall D, López-García L, Vega-Memije ME, Lacy-Niebla RM, García-Corona C, Ramírez-Rentería C, et al. HLA-DR6 association confers increased resistance to T. rubrum onychomycosis in Mexican Mestizos. Int J Dermatol. 2010;49:1406-9.
14. Gupta AK, Taborda P, Taborda V, Gilmour J, Rachlis A, Salit I, et al. Epidemiology and prevalence of onychomycosis in HIVpositive individuals. Int J Dermatol. 2000;39:746-53.
15. Gupta AK, Konnikov N, MacDonald P, Rich P, Rodger NW, Edmonds MW, et al. Prevalence and epidemiology of toenail onychomycosis in diabetic subjects: A multicentre survey. Br J Dermatol. 1998;139:665-71.
16. Zuluaga A de CA, de Bedout C, Tabares A, Cano LE, Restrepo A, Arango M, et al. Comportamiento de los agentes etiológicos de la onicomicosis en un laboratorio de micología de referencia (Medellín, 1994-2003). Fecha de consulta: 29 de septiembre de 2011. Disponible en: http://www.medcutan-ila.org/articulos/2005/6/pdf/04-084.pdf
17. Álvarez MI, González LA, Castro LA. Onychomycosis in Cali, Colombia. Mycopathologia. 2004;158:181-6.
18. Escobar ML, Carmona-Fonseca J. Onychomycosis by common non-dermatophyte moulds. Rev Iberoam Micol. 2003;20:6-10.
19. Castro N, Casas C, Sopó L, Rojas A, Del Portillo P, Cepero MC, et al. Fusarium species detected in onychomycosis in Colombia. Mycoses. 2008. Fecha de consulta: 29 de septiembre de 2011. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/18793261
20. Escobar ML, Carmona-Fonseca J, Santamaría L. Onychomycosis due to Malassezia. Rev Iberoam Micol. 1999;16:225-9.
21. Zaias N. Onychomycosis. Arch Dermatol. 1972;105:263-74. 22. Hay RJ, Baran R. Onychomycosis: A proposed revision of the clinical classification. J Am Acad Dermatol. 2011. Fecha de consulta: 29 de septiembre de 2011. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/21501889.
23. Roberts DT, Evans EG. Subungual dermatophytoma complicating dermatophyte onychomycosis. Br J Dermatol. 1998;138:189-90.
24. Baran R, Faergemann J, Hay RJ. Superficial white onychomycosis –a syndrome with different fungal causes and paths of infection. J Am Acad Dermatol. 2007;57:879-82.
25. Piraccini BM, Tosti A. White superficial onychomycosis: Epidemiological, clinical, and pathological study of 79 patients. Arch Dermatol. 2004;140:696-701.
26. Baran R, Hay R, Perrin C. Superficial white onychomycosis revisited. J Eur Acad Dermatol Venereol. 2004;18:569-71.
27. Tosti A, Baran R, Piraccini BM, Fanti PA. «Endonyx» onychomycosis: A new modality of nail invasion by dermatophytes. Acta Derm Venereol. 1999;79:52-3.
28. Baran R, McLoone N, Hay RJ. Could proximal white subungual onychomycosis be a complication of systemic spread? The lessons to be learned from maladie dermatophytique and other deep infections. Br J Dermatol. 2005;153:1023-5.
29. Mayou SC, Calderón RA, Goodfellow A, Hay RJ. Deep (subcutaneous) dermatophyte infection presenting with unilateral lymphoedema. Clin Exp Dermatol. 1987;12:385-8.
30. Boutati EI, Anaissie EJ. Fusarium, a significant emerging pathogen in patients with hematologic malignancy: Ten years experience at a cancer center and implications for management. Blood. 1997;90:999-1008.
31. King BA, Seropian S, Fox LP. Disseminated Fusarium infection with muscle involvement. J Am Acad Dermatol. 2011;65:235-7.
32. Feuilhade M. New diagnostic techniques. J Eur Acad Dermatol Venereol. 2005;19(Suppl.1):20-4.
33. Alberhasky RC. Laboratory diagnosis of onychomycosis. Clin Podiatr Med Surg. 2004;21:565-78.
34. Gupta AK, Drummond-Main C, Cooper EA, Brintnell W, Piraccini BM, Tosti A. Systematic review of non-dermatophyte mold onychomycosis: Diagnosis, clinical types, epidemiology, and treatment. J Am Acad Dermatol. 2011. Fecha de consulta: 29 de septiembre de 2011. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/21820203
35. Scher RK, Tavakkol A, Sigurgeirsson B, Hay RJ, Joseph WS, Tosti A, et al. Onychomycosis: Diagnosis and definition of cure. J Am Acad Dermatol. 2007;56:939-44.
36. Lawry MA, Haneke E, Strobeck K, Martin S, Zimmer B, Romano PS. Methods for diagnosing onychomycosis: A comparative study and review of the literature. Arch Dermatol. 2000;136:1112-6.
37. Gómez LM, Massaro M,Tabares AM, Zuluaga A, Vélez JD, Vélez A, et al. Utilidad de la muestra de la lámina ungular en el diagnóstico de onicomicosis. Fecha de consulta: 20 de octubre de 2011. Disponible en http://www.revistasocolderma.com/numeros/septiembre11/pdf
38. Moreno G, Arenas R. Other fungi causing onychomycosis. Clin Dermatol. 2010;28:160-3.
39. Gupta AK, Ryder JE, Summerbell RC. The diagnosis of non dermatophyte mold onychomycosis. Int J Dermatol. 2003;42:272-3.
40. Iorizzo M, Piraccini BM, Tosti A. Today’s treatments options for onychomycosis. J Dtsch Dermatol Ges. 2010;8:875-9.
41. Gupta AK, Tu LQ. Therapies for onychomycosis: A review. Dermatol Clin. 2006;24:375-9.
42. Baran R, Kaoukhov A. Topical antifungal drugs for the treatment of onychomycosis: An overview of current strategies for monotherapy and combination therapy. J Eur Acad Dermatol Venereol. 2005;19:21-9.
43. Albert SF, Weis ZH. Management of onychomycosis with topicals. Clin Podiatr Med Surg. 2004;21:605-15.
44. Subissi A, Monti D, Togni G, Mailland F. Ciclopirox: Recent nonclinical and clinical data relevant to its use as a topical antimycotic agent. Drugs. 2010;70:2133-52.
45. Schaller M, Borelli C, Berger U, Walker B, Schmidt S, Weindl G, et al. Susceptibility testing of amorolfine, bifonazole and ciclopiroxolamine against Trichophyton rubrum in vivo? an in vitro model of dermatophyte nail infection. Med Mycol. 2009;47:753-8.
46. Monti D, Saccomani L, Chetoni P, Burgalassi S, Senesi S, Ghelardi E, et al. Hydrosoluble medicated nail lacquers: In vitro drug permeation and corresponding antimycotic activity. Br J Dermatol. 2010;162:311-7.
47. Finch JJ, Warshaw EM. Toenail onychomycosis: Current and future treatment options. Dermatol Ther. 2007;20:31-46.
48. Joseph WS. The oral antifungal patient. Clin Podiatr Med Surg. 2004;21:591-604.
49. Gupta AK, Uro M, Cooper EA. Onychomycosis therapy: Past, present, future. J Drugs Dermatol. 2010;9:1109-13.
50. Gupta AK, Cooper EA. Update in antifungal therapy of dermatophytosis. Mycopathologia. 2008;166:353-67.
51. Gianni C. Update on antifungal therapy with terbinafine. G Ital Dermatol Venereol. 2010;145:415-24.
52. Wenig JA. The systemic treatment of onychomycosis. Clin Podiatr Med Surg. 2004;21:579-89.
53. Evans EG, Sigurgeirsson B. Double blind, randomized study of continuous terbinafine compared with intermittent itraconazole in treatment of toenail onychomycosis. The LION Study Group. BMJ. 1999;318:1031-5.
54. Warshaw EM, Fett DD, Bloomfield HE, Grill JP, Nelson DB, Quintero V, et al. Pulse versus continuous terbinafine for onychomycosis: A randomized, double-blind, controlled trial. J Am Acad Dermatol. 2005;53:578-84.
55. Olafsson JH, Sigurgeirsson B, Baran R. Combination therapy for onychomycosis. Br J Dermatol. 2003;149(Suppl.65):15-8.
56. Baran R, Sigurgeirsson B, de Berker D, Kaufmann R, Lecha M, Faergemann J, et al. A multicentre, randomized, controlled study of the efficacy, safety and cost-effectiveness of a combination therapy with amorolfine nail lacquer and oral terbinafine compared with oral terbinafine alone for the treatment of onychomycosis with matrix involvement. Br J Dermatol. 2007;157:149-57.
57. Rigopoulos D, Katoulis AC, Ioannides D, Georgala S, Kalogeromitros D, Bolbasis I, et al. A randomized trial of amorolfine 5% solution nail lacquer in association with itraconazole pulse therapy compared with itraconazole alone in the treatment of Candida fingernail onychomycosis. Br J Dermatol. 2003;149:151-6.
58. Gupta AK, Lynde CW, Konnikov N. Single-blind, randomized, prospective study of sequential itraconazole and terbinafine pulse compared with terbinafine pulse for the treatment of toenail onychomycosis. J Am Acad Dermatol. 2001;44:485-91.
59. Baran R, Hay RJ, Garduno JI. Review of antifungal therapy, part II: Treatment rationale, including specific patient populations. J Dermatolog Treat. 2008;19):168-–75.
60. Gilaberte Y, Aspiroz C, Martes MP, Alcalde V, Espinel-Ingroff A, Rezusta A. Treatment of refractory fingernail onychomycosis caused by non dermatophyte molds with methylaminolevulinate photodynamic therapy. J Am Acad Dermatol. 2011;65:669-71.
61. Hochman LG. Laser treatment of onychomycosis using a novel 0.65-millisecond pulsed Nd:YAG 1064-nm laser. J Cosmet Laser Ther. 2011;13:2-5.
62. Scher RK, Baran R. Onychomycosis in clinical practice: Factors contributing to recurrence. Br J Dermatol. 2003;149(Suppl.6)5:5-9.
2. Welsh O, Vera-Cabrera L, Welsh E. Onychomycosis. Clin Dermatol. 2010;28:151-9.
3. Scher RK. Onychomycosis: A significant medical disorder. J Am Acad Dermatol. 1996;35:S2-5.
4. Effendy I, Lecha M, Feuilhade M, Di Chiacchio N, Baran R. Epidemiology and clinical classification of onychomycosis. J Eur Acad Dermatol Venereol. 2005;19 (Suppl.1):8-12.
5. Rodríguez-Pazos L, Pereiro-Ferreirós MM, Pereiro M Jr, Toribio J. Onychomycosis observed in children over a 20-year period. Mycoses. 2011;54:450-3.
6. Manzano-Gayosso P, Méndez-Tovar LJ, Arenas R, HernándezHernández F, Millán-Chiu B, Torres-Rodríguez JM, et al. Onychomycosis-causing yeasts in four Mexican dermatology centers and their antifungal susceptibility to azolic compounds. Rev Iberoam Micol. 2011;28:32-5.
7. Ghannoum MA, Hajjeh RA, Scher R, Konnikov N, Gupta AK, Summerbell R, et al. A large-scale North American study of fungal isolates from nails: The frequency of onychomycosis, fungal distribution, and antifungal susceptibility patterns. J Am Acad Dermatol. 2000;43:641-8.
8. Vender RB, Lynde CW, Poulin Y. Prevalence and epidemiology of onychomycosis. J Cutan Med Surg. 2006;10(Suppl.2):S28-33.
9. Tosti A, Hay R, Arenas-Guzmán R. Patients at risk of onychomycosis –risk factor identification and active prevention. J Eur Acad Dermatol Venereol. 2005;19(Suppl.1):13-6.
10. Zaias N, Tosti A, Rebell G, Morelli R, Bardazzi F, Bieley H, et al. Autosomal dominant pattern of distal subungual onychomycosis caused by Trichophyton rubrum. J Am Acad Dermatol. 1996;34:302-4.
11. Zaitz C, Campbell I, Moraes JR, Moraes ME, Gouvea C, Romero M, et al. HLA-associated susceptibility to chronic onychomycosis in Brazilian Ashkenazic Jews. Int J Dermatol. 1996;35:681-2.
12. García-Romero MT, Granados J, Vega-Memije ME, Arenas R. Analysis of genetic polymorphism of the HLA-B and HLA-DR loci in patients with dermatophytic onychomycosis and in their firstdegree relatives. Actas Dermo-Sifiliogr. 2011. Fecha de consulta: 29 de septiembre de 2011. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/21742300
13. Asz-Sigall D, López-García L, Vega-Memije ME, Lacy-Niebla RM, García-Corona C, Ramírez-Rentería C, et al. HLA-DR6 association confers increased resistance to T. rubrum onychomycosis in Mexican Mestizos. Int J Dermatol. 2010;49:1406-9.
14. Gupta AK, Taborda P, Taborda V, Gilmour J, Rachlis A, Salit I, et al. Epidemiology and prevalence of onychomycosis in HIVpositive individuals. Int J Dermatol. 2000;39:746-53.
15. Gupta AK, Konnikov N, MacDonald P, Rich P, Rodger NW, Edmonds MW, et al. Prevalence and epidemiology of toenail onychomycosis in diabetic subjects: A multicentre survey. Br J Dermatol. 1998;139:665-71.
16. Zuluaga A de CA, de Bedout C, Tabares A, Cano LE, Restrepo A, Arango M, et al. Comportamiento de los agentes etiológicos de la onicomicosis en un laboratorio de micología de referencia (Medellín, 1994-2003). Fecha de consulta: 29 de septiembre de 2011. Disponible en: http://www.medcutan-ila.org/articulos/2005/6/pdf/04-084.pdf
17. Álvarez MI, González LA, Castro LA. Onychomycosis in Cali, Colombia. Mycopathologia. 2004;158:181-6.
18. Escobar ML, Carmona-Fonseca J. Onychomycosis by common non-dermatophyte moulds. Rev Iberoam Micol. 2003;20:6-10.
19. Castro N, Casas C, Sopó L, Rojas A, Del Portillo P, Cepero MC, et al. Fusarium species detected in onychomycosis in Colombia. Mycoses. 2008. Fecha de consulta: 29 de septiembre de 2011. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/18793261
20. Escobar ML, Carmona-Fonseca J, Santamaría L. Onychomycosis due to Malassezia. Rev Iberoam Micol. 1999;16:225-9.
21. Zaias N. Onychomycosis. Arch Dermatol. 1972;105:263-74. 22. Hay RJ, Baran R. Onychomycosis: A proposed revision of the clinical classification. J Am Acad Dermatol. 2011. Fecha de consulta: 29 de septiembre de 2011. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/21501889.
23. Roberts DT, Evans EG. Subungual dermatophytoma complicating dermatophyte onychomycosis. Br J Dermatol. 1998;138:189-90.
24. Baran R, Faergemann J, Hay RJ. Superficial white onychomycosis –a syndrome with different fungal causes and paths of infection. J Am Acad Dermatol. 2007;57:879-82.
25. Piraccini BM, Tosti A. White superficial onychomycosis: Epidemiological, clinical, and pathological study of 79 patients. Arch Dermatol. 2004;140:696-701.
26. Baran R, Hay R, Perrin C. Superficial white onychomycosis revisited. J Eur Acad Dermatol Venereol. 2004;18:569-71.
27. Tosti A, Baran R, Piraccini BM, Fanti PA. «Endonyx» onychomycosis: A new modality of nail invasion by dermatophytes. Acta Derm Venereol. 1999;79:52-3.
28. Baran R, McLoone N, Hay RJ. Could proximal white subungual onychomycosis be a complication of systemic spread? The lessons to be learned from maladie dermatophytique and other deep infections. Br J Dermatol. 2005;153:1023-5.
29. Mayou SC, Calderón RA, Goodfellow A, Hay RJ. Deep (subcutaneous) dermatophyte infection presenting with unilateral lymphoedema. Clin Exp Dermatol. 1987;12:385-8.
30. Boutati EI, Anaissie EJ. Fusarium, a significant emerging pathogen in patients with hematologic malignancy: Ten years experience at a cancer center and implications for management. Blood. 1997;90:999-1008.
31. King BA, Seropian S, Fox LP. Disseminated Fusarium infection with muscle involvement. J Am Acad Dermatol. 2011;65:235-7.
32. Feuilhade M. New diagnostic techniques. J Eur Acad Dermatol Venereol. 2005;19(Suppl.1):20-4.
33. Alberhasky RC. Laboratory diagnosis of onychomycosis. Clin Podiatr Med Surg. 2004;21:565-78.
34. Gupta AK, Drummond-Main C, Cooper EA, Brintnell W, Piraccini BM, Tosti A. Systematic review of non-dermatophyte mold onychomycosis: Diagnosis, clinical types, epidemiology, and treatment. J Am Acad Dermatol. 2011. Fecha de consulta: 29 de septiembre de 2011. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/21820203
35. Scher RK, Tavakkol A, Sigurgeirsson B, Hay RJ, Joseph WS, Tosti A, et al. Onychomycosis: Diagnosis and definition of cure. J Am Acad Dermatol. 2007;56:939-44.
36. Lawry MA, Haneke E, Strobeck K, Martin S, Zimmer B, Romano PS. Methods for diagnosing onychomycosis: A comparative study and review of the literature. Arch Dermatol. 2000;136:1112-6.
37. Gómez LM, Massaro M,Tabares AM, Zuluaga A, Vélez JD, Vélez A, et al. Utilidad de la muestra de la lámina ungular en el diagnóstico de onicomicosis. Fecha de consulta: 20 de octubre de 2011. Disponible en http://www.revistasocolderma.com/numeros/septiembre11/pdf
38. Moreno G, Arenas R. Other fungi causing onychomycosis. Clin Dermatol. 2010;28:160-3.
39. Gupta AK, Ryder JE, Summerbell RC. The diagnosis of non dermatophyte mold onychomycosis. Int J Dermatol. 2003;42:272-3.
40. Iorizzo M, Piraccini BM, Tosti A. Today’s treatments options for onychomycosis. J Dtsch Dermatol Ges. 2010;8:875-9.
41. Gupta AK, Tu LQ. Therapies for onychomycosis: A review. Dermatol Clin. 2006;24:375-9.
42. Baran R, Kaoukhov A. Topical antifungal drugs for the treatment of onychomycosis: An overview of current strategies for monotherapy and combination therapy. J Eur Acad Dermatol Venereol. 2005;19:21-9.
43. Albert SF, Weis ZH. Management of onychomycosis with topicals. Clin Podiatr Med Surg. 2004;21:605-15.
44. Subissi A, Monti D, Togni G, Mailland F. Ciclopirox: Recent nonclinical and clinical data relevant to its use as a topical antimycotic agent. Drugs. 2010;70:2133-52.
45. Schaller M, Borelli C, Berger U, Walker B, Schmidt S, Weindl G, et al. Susceptibility testing of amorolfine, bifonazole and ciclopiroxolamine against Trichophyton rubrum in vivo? an in vitro model of dermatophyte nail infection. Med Mycol. 2009;47:753-8.
46. Monti D, Saccomani L, Chetoni P, Burgalassi S, Senesi S, Ghelardi E, et al. Hydrosoluble medicated nail lacquers: In vitro drug permeation and corresponding antimycotic activity. Br J Dermatol. 2010;162:311-7.
47. Finch JJ, Warshaw EM. Toenail onychomycosis: Current and future treatment options. Dermatol Ther. 2007;20:31-46.
48. Joseph WS. The oral antifungal patient. Clin Podiatr Med Surg. 2004;21:591-604.
49. Gupta AK, Uro M, Cooper EA. Onychomycosis therapy: Past, present, future. J Drugs Dermatol. 2010;9:1109-13.
50. Gupta AK, Cooper EA. Update in antifungal therapy of dermatophytosis. Mycopathologia. 2008;166:353-67.
51. Gianni C. Update on antifungal therapy with terbinafine. G Ital Dermatol Venereol. 2010;145:415-24.
52. Wenig JA. The systemic treatment of onychomycosis. Clin Podiatr Med Surg. 2004;21:579-89.
53. Evans EG, Sigurgeirsson B. Double blind, randomized study of continuous terbinafine compared with intermittent itraconazole in treatment of toenail onychomycosis. The LION Study Group. BMJ. 1999;318:1031-5.
54. Warshaw EM, Fett DD, Bloomfield HE, Grill JP, Nelson DB, Quintero V, et al. Pulse versus continuous terbinafine for onychomycosis: A randomized, double-blind, controlled trial. J Am Acad Dermatol. 2005;53:578-84.
55. Olafsson JH, Sigurgeirsson B, Baran R. Combination therapy for onychomycosis. Br J Dermatol. 2003;149(Suppl.65):15-8.
56. Baran R, Sigurgeirsson B, de Berker D, Kaufmann R, Lecha M, Faergemann J, et al. A multicentre, randomized, controlled study of the efficacy, safety and cost-effectiveness of a combination therapy with amorolfine nail lacquer and oral terbinafine compared with oral terbinafine alone for the treatment of onychomycosis with matrix involvement. Br J Dermatol. 2007;157:149-57.
57. Rigopoulos D, Katoulis AC, Ioannides D, Georgala S, Kalogeromitros D, Bolbasis I, et al. A randomized trial of amorolfine 5% solution nail lacquer in association with itraconazole pulse therapy compared with itraconazole alone in the treatment of Candida fingernail onychomycosis. Br J Dermatol. 2003;149:151-6.
58. Gupta AK, Lynde CW, Konnikov N. Single-blind, randomized, prospective study of sequential itraconazole and terbinafine pulse compared with terbinafine pulse for the treatment of toenail onychomycosis. J Am Acad Dermatol. 2001;44:485-91.
59. Baran R, Hay RJ, Garduno JI. Review of antifungal therapy, part II: Treatment rationale, including specific patient populations. J Dermatolog Treat. 2008;19):168-–75.
60. Gilaberte Y, Aspiroz C, Martes MP, Alcalde V, Espinel-Ingroff A, Rezusta A. Treatment of refractory fingernail onychomycosis caused by non dermatophyte molds with methylaminolevulinate photodynamic therapy. J Am Acad Dermatol. 2011;65:669-71.
61. Hochman LG. Laser treatment of onychomycosis using a novel 0.65-millisecond pulsed Nd:YAG 1064-nm laser. J Cosmet Laser Ther. 2011;13:2-5.
62. Scher RK, Baran R. Onychomycosis in clinical practice: Factors contributing to recurrence. Br J Dermatol. 2003;149(Suppl.6)5:5-9.
Cómo citar
1.
Mendoza N, Palacios C, Cardona N, Gómez LM. Onicomicosis: afección común de difícil tratamiento. rev. asoc. colomb. dermatol. cir. dematol. [Internet]. 1 de abril de 2012 [citado 18 de abril de 2024];20(2):149-58. Disponible en: https://revista.asocolderma.org.co/index.php/asocolderma/article/view/224
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2012-04-01
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Mendoza N, Palacios C, Cardona N, Gómez LM. Onicomicosis: afección común de difícil tratamiento. rev. asoc. colomb. dermatol. cir. dematol. [Internet]. 1 de abril de 2012 [citado 18 de abril de 2024];20(2):149-58. Disponible en: https://revista.asocolderma.org.co/index.php/asocolderma/article/view/224
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