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Onychomycosis Unresponsive to Antifungals: Etiology and Treatment with a New Direct Technique
Fatma Gülru Erdogan1, Dilsun Yıldırım2, Gül Aslıhan Çakır Akay1
1Department of Dermatology, Ufuk University Faculty of Medicine, Turkey.
Aims And Objectives:
The aim of this study was to identify the fungal agents causing onychomycosis that were unresponsive to antifungal treatment and to treat these cases by placing under-nail cushions with a mild keratolytic to clear the fungus-invaded tissue.
Materials And Methods:
Fungal agents were identified by the matrix-assisted laser desorption/ionization time of flight (MALDI-TOF) technique.
Results:
Nine patients had Aspergillus spp. (7 Aspergillus niger, 2 Aspergillus flavus); four had Candida species and one had Trichophyton rubrum. All patients were free of infection at the end of treatment.
Conclusion:
As per the results, we may state that onychomycosis that is unresponsive to treatment in immunocompetent patients seems to be mostly associated with molds. Direct application of a mild keratolytic to the fungus-invaded part, e.g., the nail plate and/or nail bed and removal of fungal elements may provide a successful treatment outcome.
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