Pathophysiology and Management of Onychomycosis and Novel Approaches for Effective Transdermal Applications
Author(s): Dharmian Jose Prakash, Sathiyaseelan Iraniammal, Renganathan Akshaya, Mubees Alamaan Mohamed, Naser Mohammed Yasin Abdul, Ramkrishnan Prakash, Arumugam Somasundaram
Issue: Nov/Dec 2023 - Volume 27, Number 6
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Page(s): 494-502
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Abstract: Onychomycosis is the most common fungal nail infection accounting for 50% of nail disorders. This infection is most common in the toenails than in the nails of the fingers. It is caused by various fungal species like Trichophyton rubrum, Trichophyton mentagrophytes, Scopulariopsis brevicaulis, Aspergillus spp, Fusarium spp, Acremonium spp, Alternaria spp, and Neoscytalidium. Among them, dermatophyte fungus is involved in 70% to 80% of infections. Clinically, there are five types of onychomycosis classified based on causative organism and location of infection origin. Diagnosis of this infection uses a mycological study of nail samples using multiple staining techniques like periodic acid-Schiff, calcofluor, Grocott methenamine silver, fluorescence, and microscopy. The major risk factors of this infection include diabetes mellitus, psoriasis, peripheral vascular diseases, obesity, metabolic syndrome, nail trauma, human immunodeficiency virus and/or acquired immunodeficiency syndrome, immune-compromised individuals, chronic kidney failure, athletic activity, smoking, and hyperlipidemia. The treatment options for onychomycosis include topical and systemic antifungal agents, nanoparticles, laser therapy, photodynamic therapy, and nail avulsion. This article describes several types of onychomycosis, symptoms, diagnosis, currently available therapy and its drawback, current research to rectify the issues, and future medicinal approaches to improve patient health.
Related Keywords: Jose Prakash Dharmian, M. Pharm, PhD, Iraniammal Sathiyaseelan, B. Pharm, Akshaya Renganathan, B. Pharm, Alamaan Mohamed Mubees, B. Pharm, Mohammed Yasin Abdul Naser, B. Pharm, Prakash Ramkrishnan, M. Pharm, PhD, Somasundaram Arumugam, M. Pharm, PhD, onychomycosis, fungal nail infection, fungi, nail fungus, transdermal applications, dermatophytes, antifungal agents, topical preparations, laser therapy, photodynamic therapy, nail avulsion, hydrogels, liposomes, microemulsions, nanoparticles, nanocapsules, nanovesicles, polymeric nanoparticles, drug penetration
Related Categories: DERMATOLOGY, PEER-REVIEWED, DOSAGE FORMS/DRUG CARRIERS, INFECTIOUS DISEASE