Justified use of 5% amorolfine nail lacquer, in the treatment of toe onychomycosis

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Abstract

The article presents the description of three clinical cases of the successful treatment of toe onychomycosis and athlete’s foot of various etiologies using 5% amorolfine antifungal nail lacquer. The first case: a 31-year-old woman was diagnosed with white superficial onychomycosis of great toe caused by Trichophyton rubrum. The treatment with 5% amorolfine once a week for 6 months resulted in full recovery (both mycological and clinical). The second case: a 42-year-old woman developed onychomycosis after the application of decorative coating on her nails; onychomycosis was caused by Scopulariopsis brevicaulis. She was treated with itraconazole pulse therapy and 5% amorolfine lacquer. She fully recovered. The third case: a 65-year-old man with total onychomycosis of 10 toes developed the skin mycosis of the left foot and lower third of the leg. He was prescribed a therapy with sertaconazole cream and 5% amorolfine lacquer. The use of 5% amorolfine lacquer was continued to prevent from recurrent dermatomycosis. Thus, the above mentioned cases are a good example of the advantages of using 5% amorolfine lacquer in the treatment of most toe onychomycosis types caused by any pathogens (dermatophytes, yeasts or molds).

About the authors

Liubov P. Kotrekhova

North-Western State Medical University named after I.I. Mechnikov

Author for correspondence.
Email: zurupalubov@inbox.ru
ORCID iD: 0000-0003-2995-4249
SPIN-code: 6628-1260

MD, Cand. Sci. (Med.), Associate Professor

Russian Federation, Saint Petersburg

Ekaterina N. Tsurupa

North-Western State Medical University named after I.I. Mechnikov

Email: riobasa@yandex.ru
ORCID iD: 0000-0002-5792-7478
SPIN-code: 6205-1530

Dermatovenerologist

Russian Federation, Saint Petersburg

Galina A. Chilina

North-Western State Medical University named after I.I. Mechnikov

Email: galina.chilina@szgmu.ru
ORCID iD: 0000-0002-9204-4662
SPIN-code: 4818-3687

Head of the Laboratory “Russian Collection of Pathogenic Fungi”

Russian Federation, Saint Petersburg

Ilia A. Bosak

North-Western State Medical University named after I.I. Mechnikov

Email: ilya.bosak@szgmu.ru
ORCID iD: 0000-0002-0193-9103
SPIN-code: 5699-5857

Cand. Sci. (Biol.), Senior Researcher

Russian Federation, Saint Petersburg

Arina A. Vashkevich

North-Western State Medical University named after I.I. Mechnikov

Email: aavashk@mail.ru
ORCID iD: 0000-0002-3933-6922
SPIN-code: 6254-9643

MD, Cand. Sci. (Med.), Associate Professor

Russian Federation, Saint Petersburg

References

  1. Sigurgeirsson B, Baran R. The prevalence of onychomycosis in the global population: a literature study. J Eur Acad Dermatol Venereol. 2014;28(11):1480–1491. doi: 10.1111/jdv.12323
  2. Gupta AK, Stec N, Summerbell RC, et al. Onychomycosis: a review. J Eur Acad Dermatol Venereol. 2020;34(9):1972–1990. doi: 10.1111/jdv.16394
  3. Gupta AK, Venkataraman M, Talukder M. Onychomycosis in older adults: prevalence, diagnosis, and management. Drugs Aging. 2022;39(3):191–198. doi: 10.1007/s40266-021-00917-8
  4. Thomas J, Jacobson GA, Narkowicz CK, Peterson GM, Burnet H, Sharpe C. Toenail onychomycosis: an important global disease burden. J Clin Pharm Ther. 2010;35(5):497–519. doi: 10.1111/j.1365-2710.2009.01107.x
  5. Васильева Н.В., Разнатовский К.И., Котрехова Л.П., и др. Этиология онихомикоза стоп в г. Санкт-Петербурге и г. Москве. Результаты проспективного открытого многоцентрового исследования. Проблемы медицинской микологии. 2009;11(2):14–18. [Etiology of feet onychomycoses in Saint Petersburg and Moscow. Results of prospective open multicentral study. Problems in medical mycology. 2009;11(2):14–18. (In Russ.)]
  6. Gupta AK, Drummond-Main C, Cooper EA, Brintnell W, Piraccini BM, Tosti A. Systematic review of nondermatophyte mold onychomycosis: diagnosis, clinical types, epidemiology, and treatment. J Am Acad Dermatol. 2012;66(3):494–502. doi: 10.1016/j.jaad.2011.02.038
  7. Gupta AK, Venkataraman M, Renaud HJ, Summerbell R, Shear NH, Piguet V. A paradigm shift in the treatment and management of onychomycosis. Skin Appendage Disord. 2021;7(5):351–358. doi: 10.1159/000516112
  8. Gupta AK, Cernea M, Foley KA. Improving Cure Rates in Onychomycosis. J Cutan Med Surg. 2016;20(6):517–531. doi: 10.1177/1203475416653734
  9. Bristow IR, Baran R. Topical and oral combination therapy for toenail onychomycosis: an updated review. J Am Podiatr Med Assoc. 2006;96(2):116–119. doi: 10.7547/0960116
  10. Gupta AK, Versteeg SG, Shear NH. Onychomycosis in the 21st century: an update on diagnosis, epidemiology, and treatment. J Cutan Med Surg. 2017;21(6):525–539. doi: 10.1177/1203475417716362
  11. Gupta AK, Studholme C. How do we measure efficacy of therapy in onychomycosis: patient, physician, and regulatory perspectives. J Dermatolog Treat. 2016;27(6):498–504. doi: 10.3109/09546634.2016.1161156
  12. Sigurgeirsson B, Olafsson JH, Steinsson JT, Kerrouche N, Sidou F. Efficacy of amorolfine nail lacquer for the prophylaxis of onychomycosis over 3 years. J Eur Acad Dermatol Venereol. 2010;24(8):910–915. doi: 10.1111/j.1468-3083.2009.03547.x
  13. Gupta AK, Ryder JE, Baran R. The use of topical therapies to treat onychomycosis. Dermatol Clin. 2003;21(3):481–489. doi: 10.1016/s0733-8635(03)00025-1
  14. Lecha M. Amorolfine and itraconazole combination for severe toenail onychomycosis; results of an open randomized trial in Spain. Br J Dermatol. 2001;145(Suppl60):21–26.
  15. Tabara K, Szewczyk AE, Bienias W, Wojciechowska A, Pastuszka M, Oszukowska M, et al. Amorolfine vs. ciclopirox — lacquers for the treatment of onychomycosis. Postepy Dermatol Alergol. 2015;32(1):40–45. doi: 10.5114/pdia.2014.40968
  16. Evans EG. Drug synergies and the potential for combination therapy in onychomycosis. Br J Dermatol. 2003;149(Suppl65):11–13. doi: 10.1046/j.1365-2133.149.s65.1.x
  17. Ghannoum M, Long L, Kunze G, Sarkany M, Osman-Ponchet H. A pilot, layerwise, ex vivo evaluation of the antifungal efficacy of amorolfine 5% nail lacquer vs other topical antifungal nail formulations in healthy toenails. Mycoses. 2019;62(6):494–501. doi: 10.1111/myc.12896
  18. Polak A, Jäckel A, Noack A, Kappe R. Agar sublimation test for the in vitro determination of the antifungal activity of morpholine derivatives. Mycoses. 2004;47(5–6):184–192. doi: 10.1111/j.1439-0507.2004.00975.x
  19. Sigurgeirsson B, Ghannoum MA, Osman-Ponchet H, Kerrouche N, Sidou F. Application of cosmetic nail varnish does not affect the antifungal efficacy of amorolfine 5% nail lacquer in the treatment of distal subungual toenail onychomycosis: results of a randomised active-controlled study and in vitro assays. Mycoses. 2016;59(5):319–326. doi: 10.1111/myc.12473

Supplementary files

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2. Fig. 1. Onychomycosis caused by T. rubrum: а — Morphological elements of T. rubrum — luminous mycelium in a scraping of the nail plates of the first toes under fluorescent microscopy, stained with calcofluor white, ×400; б — upper surface of a T. rubrum colony on potato agar: white, fluffy with a red rim; в — lower surface of the same colony, intense red; г — light microscopy of a culture of T. rubrum showing the characteristic pear-shaped microconidia; д — white superficial onychomycosis of the first toes caused by T. rubrum; е — healthy nail plates in woman 12 months after starting treatment for white superficial onychomycosis with 5% amorolfine lacquer twice a week for 6 months, then once a week for up to 1 year or more

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3. Fig. 2. Onychomycosis caused by S. brevicaulis. а — morphological elements of S. brevicaulis — septate hyphae in the scraping of the nail plate of the first toe of the right foot on microscopy with KOH, ×400; в — luminous numerous large spores of S. brevicaulis under fluorescent microscopy, stained with calcofluor white, ×400; в — light microscopy of a culture of S. brevicaulis: numerous spores and spore-bearing organs in the form of irregular brushes; г — S. brevicaulis characteristic colony with a fluffy upper surface, sandy white on S. brevicaulis characteristic colony with a fluffy upper surface, sandy white on Sabouraud’s agar; д — distal-lateral and proximal nail lesion of the 1st toe of the right foot in onychomycosis caused by S. brevicaulis in a 42-year-old woman; е — complete recovery (clinical and mycological) in a 42-year-old woman treated with 3 pulses of itraconazole and Loceryl® varnish once a week for 6 months from the start of therapy

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4. Fig. 3. Onychomycosis caused by T. interdigitale. а — tinea pedis and shin and total onychomycosis caused by T. interdigitale in a 65-year-old patient that developed against the background of ankylosing spondylitis and methotrexate intake — 15 mg per week for 10 years; б — complete resolution of tinea pedis and shin with sertaconazole cream after 3 weeks of treatment; в — absence of recurrence of skin mycosis against the background of prophylactic application of Loceryl® varnish (5% amorolfine) once a week

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Copyright (c) 2023 Kotrekhova L.P., Tsurupa E.N., Chilina G.A., Bosak I.A., Vashkevich A.A.

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