Conceptual and theoretical exploration of treatment of patients with onychomycosis

Abstract

Objective: To optimize medical care for patients with onychomycosis by adding agents that improve nail plate structure to systemic antifungal therapy. Materials and methods: The study included 147 patients aged 23–79 years with various forms of onychomycosis of hands and feet. Patients were randomized into a main group receiving a systemic antifungal drug plus a biotin-containing agent aimed at improving nail plate structure and regrowth, and a control group receiving systemic antifungal therapy only. Diagnostic assessment included microscopy of nail fragments, culture, PCR, epiluminescence surface microscopy, dermatoscopy, and calculation of a nail plate damage index. Results: Combined therapy increased nail plate growth rate 1.4-fold compared with control (0.77±0.02 cm vs 0.53±0.03 cm). Conclusions: A comprehensive approach combining antifungal treatment with nail-structure–supporting agents provides mycological elimination and better clinical outcomes, achieving mycological remission at 10–12 weeks in 89.1% of patients, which is 19.5% higher than with traditional treatment. Restoration of normal nail plate structure was achieved in 96.8% of patients (vs 81.5% in controls).