The Positive Impact of Combined Treatment of Tazarotene and Systemic Antifungal on Onychomycosis

Document Type : New and original researches in the field of Microbiology.

Authors

1 Department of Dermatology, Faculty of Medicine, Fayoum University, Fayoum, Egypt.

2 Department of Medical Microbiology and Immunology, Faculty of Medicine, Fayoum University, Fayoum, Egypt.

3 Medical Microbiology and Immunology Fayoum University Faculty of Medicine

Abstract

Background: Onychomycosis is a nail plate fungal infection with low initial cure rates and high relapse. Current treatment choices consist of topical and oral therapies. Tazarotene is a synthetic retinoid, with anti-inflammatory activities. Objectives: to investigate the effect of topical Tazarotene with and without systemic antifungal as a treatment of onychomycosis. Methodology: This work is a prospective, comparative, observational study. Thirty onychomycosis patients (with nail changes) were recruited out of 300 patients admitted to the dermatology clinic at Fayoum University Hospital , they were divided into three groups, group I: 10 patients treated with topical Tazarotene,  group II: 10 patients treated with systemic antifungals, and  group III: 10 patients treated with both. The groups were evaluated clinically by onychomycosis severity index (OSI) and laboratory by direct film and fungal culture of nail samples taken by scraping or clipping before and after treatment of all patients. Results: Trichophyton mentagrophyte (20%), was the commonest isolated fungus followed by Epidermophytone floccosum and candida species (13.3% each).  After 3 months of treatment: (group I) showed improvement clinically with no lesion within 30% of patients (especially lesions of mild and moderate cases). Also (group II) showed improvement in cases cured with 50% of patients with no lesion. Group III showed 70% of patients (all cases especially severe cases) clinically no lesion. Conclusion: Combined treatment of Tazarotene and systemic antifungal has a worthy clinical effect on all onychomycosis especially severe cases also Tazarotene alone is a safe and effective cure choice for mild and moderate onychomycosis.

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