Miller RC, Lipner SR. Treatment of Fingernail Onychomycosis with Efinaconazole 10% Solution in a Patient with Scleroderma: A Case Report.
Skin Appendage Disord 2022;
8:350-353. [PMID:
35979526 PMCID:
PMC9274809 DOI:
10.1159/000522407]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 02/01/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction
Oral antifungals are typically preferred over topicals for moderate to severe onychomycosis due to efficacy and shorter treatment courses. However, systemics are contraindicated or cautioned in patients with liver dysfunction and with some autoimmune diseases, and in those taking interacting medications. Efinaconazole 10% solution is a topical antifungal therapy, but application for fingernail onychomycosis has not been adequately studied.
Case Presentation
We present a case of a 78-year-old female with scleroderma and moderate onychomycosis of the right 4th fingernail successfully treated with topical efinaconazole 10% solution.
Conclusion
We review the literature on contraindications to oral antifungals for onychomycosis, precautions with terbinafine in patients with some autoimmune diseases, and topical onychomycosis therapies. Topical efinaconazole may represent an effective alternative for patients with fingernail onychomycosis who have contraindications to oral medications.
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