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Onychomycosis in the elderly.

A K Gupta1

  • 1Department of Medicine, Sunnybrook and Women's College Health Sciences Center, University of Toronto, Ontario, Canada. agupta@execulink.com

Drugs & Aging
|August 12, 2000
PubMed
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Onychomycosis, a common nail fungal infection, affects more elderly males and is often caused by dermatophytes. Treatment options range from topical to oral antifungal agents, with newer oral drugs showing good tolerability in older adults.

Area of Science:

  • Dermatology
  • Mycology
  • Pharmacology

Background:

  • Onychomycosis is a prevalent nail fungal infection, particularly in the elderly and males.
  • Dermatophytes, such as Trichophyton rubrum and T. mentagrophytes, are the most common causative agents of toenail onychomycosis.
  • Differential diagnosis includes trauma, psoriasis, and lichen planus, necessitating mycological confirmation.

Purpose of the Study:

  • To review the epidemiology, clinical presentations, and differential diagnosis of onychomycosis.
  • To outline current and emerging treatment modalities for onychomycosis.
  • To discuss patient selection, monitoring, and management strategies, including recurrence prevention.

Main Methods:

  • Literature review of onychomycosis epidemiology, diagnosis, and treatment.

Related Experiment Videos

  • Analysis of approved and commonly used antifungal agents (oral and topical).
  • Discussion of treatment regimens, including duration and combination therapy.

    • Main Results:

    • Onychomycosis is more common in elderly males; distal and lateral subungual or white superficial patterns are typical.
    • Accurate diagnosis requires mycological examination, as only 50% of abnormal nails are onychomycosis.
    • Newer oral antifungals like terbinafine and itraconazole are effective and well-tolerated, especially in the elderly.

    Conclusions:

    • Effective management of onychomycosis involves accurate diagnosis and appropriate selection of antifungal therapy.
    • Combination therapy and local measures may be optimal for severe cases or specific presentations.
    • Patient counseling on recurrence prevention is crucial after successful treatment.