Review
Global perspectives for the management of onychomycosis
Aditya K. Gupta MD, PhD,
Rachel R. Mays BSc,
Sarah G. Versteeg MSc,
Bianca Maria Piraccini MD,
Anita Takwale MD,
Avner Shemer MD,
Meir Babaev MD,
Chander Grover MD, DNB,
Nilton G. Di Chiacchio MD,
Paulo R. O. Taborda MD,
Valeria B. A. Taborda MD, PhD,
Neil H. Shear M.D,
Vincent Piguet MD, PhD,
Antonella Tosti MD,
Corresponding Author
Aditya K. Gupta MD, PhD
Mediprobe Research Incorporated, London, Canada
Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Canada
Correspondence
Aditya K. Gupta, MD, PhD
Mediprobe Research Inc.
645 Windermere Road
London, Ontario
Canada N5X 2P1
E-mail: [email protected]
Search for more papers by this authorRachel R. Mays BSc
Mediprobe Research Incorporated, London, Canada
Search for more papers by this authorSarah G. Versteeg MSc
Mediprobe Research Incorporated, London, Canada
Search for more papers by this authorBianca Maria Piraccini MD
Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
Search for more papers by this authorAnita Takwale MD
Gloucestershire Royal Hospital, Gloucester, United Kingdom
Search for more papers by this authorAvner Shemer MD
Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
Search for more papers by this authorMeir Babaev MD
Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
Search for more papers by this authorChander Grover MD, DNB
Division of Dermatology and STD, University College of Medical Sciences and GTB Hospital, Delhi, India
Search for more papers by this authorNilton G. Di Chiacchio MD
Dermatology Clinic, Hospital do Servidor Público Municipal de São Paulo, São Paulo, Brazil
Search for more papers by this authorPaulo R. O. Taborda MD
Division of Dermatology, Faculdade de Medicina do ABC, Santo André, Brazil
Search for more papers by this authorValeria B. A. Taborda MD, PhD
Cosmetic Dermatology and Laser Center (Delcentro), Bauru, São Paulo, Brazil
Search for more papers by this authorNeil H. Shear M.D
Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Canada
Division of Dermatology, Sunnybrook Health Sciences Centre, Toronto, Canada
Search for more papers by this authorVincent Piguet MD, PhD
Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Canada
Division of Dermatology, Women's College Hospital, Toronto, Canada
Division of Infection and Immunity, Cardiff University School of Medicine, Cardiff, United Kingdom
Search for more papers by this authorAntonella Tosti MD
Fredric Brandt Endowed Professor of Dermatology, University of Miami, Miami, FL, USA
Search for more papers by this authorAditya K. Gupta MD, PhD,
Rachel R. Mays BSc,
Sarah G. Versteeg MSc,
Bianca Maria Piraccini MD,
Anita Takwale MD,
Avner Shemer MD,
Meir Babaev MD,
Chander Grover MD, DNB,
Nilton G. Di Chiacchio MD,
Paulo R. O. Taborda MD,
Valeria B. A. Taborda MD, PhD,
Neil H. Shear M.D,
Vincent Piguet MD, PhD,
Antonella Tosti MD,
Corresponding Author
Aditya K. Gupta MD, PhD
Mediprobe Research Incorporated, London, Canada
Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Canada
Correspondence
Aditya K. Gupta, MD, PhD
Mediprobe Research Inc.
645 Windermere Road
London, Ontario
Canada N5X 2P1
E-mail: [email protected]
Search for more papers by this authorRachel R. Mays BSc
Mediprobe Research Incorporated, London, Canada
Search for more papers by this authorSarah G. Versteeg MSc
Mediprobe Research Incorporated, London, Canada
Search for more papers by this authorBianca Maria Piraccini MD
Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
Search for more papers by this authorAnita Takwale MD
Gloucestershire Royal Hospital, Gloucester, United Kingdom
Search for more papers by this authorAvner Shemer MD
Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
Search for more papers by this authorMeir Babaev MD
Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
Search for more papers by this authorChander Grover MD, DNB
Division of Dermatology and STD, University College of Medical Sciences and GTB Hospital, Delhi, India
Search for more papers by this authorNilton G. Di Chiacchio MD
Dermatology Clinic, Hospital do Servidor Público Municipal de São Paulo, São Paulo, Brazil
Search for more papers by this authorPaulo R. O. Taborda MD
Division of Dermatology, Faculdade de Medicina do ABC, Santo André, Brazil
Search for more papers by this authorValeria B. A. Taborda MD, PhD
Cosmetic Dermatology and Laser Center (Delcentro), Bauru, São Paulo, Brazil
Search for more papers by this authorNeil H. Shear M.D
Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Canada
Division of Dermatology, Sunnybrook Health Sciences Centre, Toronto, Canada
Search for more papers by this authorVincent Piguet MD, PhD
Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Canada
Division of Dermatology, Women's College Hospital, Toronto, Canada
Division of Infection and Immunity, Cardiff University School of Medicine, Cardiff, United Kingdom
Search for more papers by this authorAntonella Tosti MD
Fredric Brandt Endowed Professor of Dermatology, University of Miami, Miami, FL, USA
Search for more papers by this authorFunding sources: None.
Conflicts of interest: AK Gupta is a clinical trials investigator and speaker for Valeant Canada, and a clinical trials investigator for Moberg, R. Mays and Sarah Versteeg were employed by Mediprobe Research Inc., a site where clinical trials are run under supervision of AK Gupta. A Tosti is principal investigator for Erchonia laser and a consultant for Almirall and Polichem.
Abstract
Onychomycosis is a fungal nail infection caused by dermatophytes, nondermatophyte molds, and yeasts. This difficult-to-treat chronic infection has a tendency to relapse despite treatment. This paper aims to offer a global perspective on onychomycosis management from expert physicians from around the world. Overall, the majority of experts surveyed used systemic, topical, and combination treatments approved in their countries and monitored patients based on the product insert or government recommendations. Although the basics of treating onychomycosis were similar between countries, slight differences in onychomycosis management between countries were found. These differences were mainly due to different approaches to adjunctive therapy, rating the severity of disease and use of prophylaxis treatment. A global perspective on the treatment of onychomycosis provides a framework of success for the committed clinician with appreciation of how onychomycosis is managed worldwide.
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