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Abstract
BACKGROUND Candida onychomycosis with chronic paronychia is a dermatological disorder that is difficult to treat. Amorolfine nail lacquer, a new topical antifungal agent, has proven effective in the treatment of onchomycosis of short duration without matrix involvement.
OBJECTIVE We evaluated the effectiveness of amorolfine nail lacquer in the treatment of long-term Candida onychomycosis with chronic paronychia.
METHODS A group of 32 patients with 57 onychomycotic fingernails with matrix involvement were treated with twice-weekly applications of amorolfine 5% nail lacquer which was also inserted in the paronychial space. The responsible fungi were Candida albicans (25), C. tropicalis (7), C. parapsilosis (2), and no pathogens were isolated from nine patients who were treated on clinical grounds only. Five clinical features (hyperkeratosis, onychodystrophy, onycholysis, paronychia and tenderness) were scored. Photographs were taken each time the patients attended for the three required follow-up assessments. Patients were not requested to discontinue wet work or to wear gloves.
RESULTS After an average 40 weeks of treatment (14–67 weeks), 90% of the nails were either cured or showed only minor signs of residual dystrophy. Tenderness and chronic paronychia responded particularly well and quickly to the treatment.
CONCLUSION Amorolfine 5% nail lacquer is effective and is the treatment of choice in chronic Candida onychomycosis with paronychia and nail matrix involvement.
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