Onychomycosis : The Current Approach to Diagnosis and Therapy

by Baran, Robert, M.D.; Hay, Roderick; Haneke, Eckart, M.D.

• ISBN13: 9781853177675
• ISBN10: 1853177679
• Format: Hardcover
• Copyright: 1999-09-01
• Publisher: Taylor & Francis

Summary

Rapid advances have been made in the development of therapies for onychomycosis, and there is therefore an increasing need for accurate diagnosis and selection of appropriate treatment. This text, written by a team of authors with expert knowledge in nail disease and fungal infection, discusses clinical presentation, diagnosis, laboratory procedures, the assessment of results and identification of possible infection, and concludes with an overview of available treatments.

Table of Contents

Preface	p. 5
Epidemiology	p. 6
Anatomy of the normal nail	p. 10
Clinical patterns correlated with main routes of entry	p. 12
Clinical differential diagnosis	p. 20
Mycological examination	p. 28
The proper collection of samples: The "How" and "Where"	p. 28
Microscopic examination	p. 30
Culture	p. 31
Histopathological examination	p. 34
Goals for the treatment of onychomycosis	p. 40
Mycological cure	p. 40
Clearance of the nail plate	p. 41
Clinical measurement and assessment of responses	p. 42
Review of current antifungal therapy	p. 44
Topical treatment	p. 44
Transungual drug delivery systems	p. 44
Nail avulsion	p. 47
Total surgical	p. 48
Partial surgical	p. 49
Chemical	p. 50
Systemic treatment with new antifungal drugs	p. 54
Itraconazole	p. 54
Fluconazole	p. 57
Terbinafine	p. 59
Treatment in the elderly	p. 63
In childhood	p. 64
In pregnant women	p. 64
In immunocompromised patients	p. 64
Rationale for a stepwise approach to therapy	p. 66
Preventive measures	p. 70
Reasons for prevention	p. 70
Genetic predisposition	p. 70
Reduced nail growth rate	p. 71
Underlying disease	p. 71
Prevention	p. 71
Index	p. 73
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