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Wheeless' Textbook of Orthopaedics
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Toe Nail Fungus (Onychomycosis)



- Discussion:
    - most often caused by dermatophytes (Trichophyton rubrum and Trichophyton interdigitale);
    - affects 3-5% of younger patients, but effects up to half of the elderly population;
   
- Treatment:
    - medicated nail polish:
            - indicated if there is only one or two involved nails;
            - typically applied twice a week until your nail is cured;
            - amorolfine (Loceryl)
            - ciclopirox (Loprox)
                    - synthetic broad-spectrum antifungal agent that inhibits the growth of dermatophytes
    - oral medications:
            - itraconazole (Sporanox);
                    - can be taken daily for 12 weeks;
                    - can be taken once a week per month for three months;
                    - drug interactions include terfenadine, astemizole, cisapride , midazolam, triazolam or lovastatin.
            - terbinafine (Lamisil);
                    - can be taken daily for 12 weeks;
            - fluconazole: is also effective against toenail fungus;





















Original Text by Clifford R. Wheeless, III, MD.