[Treatment of onychomycoses]

The author reviews the prevalence of onychomycoses and the factors influencing it. Among the precipitating factors, age and various predisposing diseases play a role in the development of the disease play a role in the development of the disease. The problem affects the toenails more frequently than the fingernails. Distal subungual onychomycosis caused by dermatophytons is most often seen among the various types of the disease. Yeasts and moulds mainly act as contaminants. New diagnostic methods facilitate more precise diagnosis but they cannot replace basic mycological investigations. Orally administered antifungal agents have appeared in the foreground of treatment. Among them fluconazole, itraconazole and terbinafin derivatives can safely be applied in combination with certain cauterants. Each of the three agents are effective in approximately 70-80% of cases, especially when applied on fingernails. Combined therapy, such as the application of oral antimycotics and antifungal lacquerers or oral treatment accompanied by the surgical, laser or chemical removal of the affected nail regions, can improve the results. Surviving fungal residues in the substance of the nail may restart the disease. Relapse may also be attributed to neglecting the desinfection of shoes. When choosing the drugs, drug interaction should also be considered. The above three oral antimycotics have few (1-20%) side effects, gastrointestinal ones being the most common among them. A transitory elevation in hepatic enzyme levels may sometimes occur but the changes go back to normal after treatment is over.