Onychomycosis worsens quality of life, warrants effective treatments

Onychomycosis has a substantial impact on the quality of life of patients and requires effective treatment, results of a systematic review have confirmed.

“All treatments resulted in quality-of-life improvements, [but] studies on oral and topical therapies were of higher quality than those evaluating devices,” the investigators said.

“Increased efforts are needed to understand the effect of the disease and therapy as assessed by validated, nail-specific outcome measures that accurately assess patients' cosmetic, physical, and social difficulties,” they added.

In this study, the investigators systematically reviewed available literature that described the effect of onychomycosis and treatment on quality of life. They performed a search of onychomycosis literature published before 13 April 2020 and identified articles that presented primary data, used patient-reported outcome measures, and specifically examined onychomycosis.

Thirty studies met the inclusion criteria for the final analysis. Women and fingernail involvement were found to be significantly associated with the poorest quality-of-life scores. However, quality-of-life scores showed improvements from baseline with all treatment types, with greater improvements observed among patients who used oral treatments compared with topical ones.

A 2015 meta-analysis revealed the superiority of 12-week continuous terbinafine 250 mg and itraconazole 400 mg pulse therapy (1 week per month for 3 months) over other treatments and suggested the equivalence of topical therapies. These findings agreed with those from literature and treatment efficacy reported in clinical practice. [J Am Podiatr Med Assoc 2015;105:357-366]

“Onychomycosis is the most common nail disorder, often causing physical, emotional, and aesthetic consequences,” the investigators said.