title: Efficacious treatment of non-dermatophyte mould onychomycosis with topical amphotericin B.
abstract: BACKGROUND
  Dermatophytes are the main cause of onychomycosis, but various non-dermatophyte moulds (NDMs) are often the infectious agents in abnormal nails. In particular, Fusarium spp. and other NDMs are mostly insensitive to standard onychomycosis treatment with topical agents as well as with oral terbinafine and itraconazole.
  
  
  OBJECTIVE
  The aim of this work is to report the efficacy of a topical amphotericin B solution on NDM onychomycosis in a series of 8 patients resistant to multiple conventional topical and systemic treatments.
  
  
  METHODS
  Treatment consisted in the application of an optimized amphotericin B solution once daily to the affected nails and surrounding tissue. No mechanical debridement or medications were allowed except for trimming excessively long nails or in some cases occasionally applying urea-based cream to soften thickened nail plates.
  
  
  RESULTS
  Onychomycosis was clinically cured in all patients after a 12-month treatment. Mycological cure was obtained in all but 1 patient.
  
  
  CONCLUSIONS
  Topical amphotericin B is an efficacious, safe, cheap and easy-to-apply treatment which should be considered as first-line therapy for NDM onychomycosis.
authors.affiliation: Department of Dermatology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
authors.forename: Massimo
authors.initials: M
authors.lastname: Lurati
authors.forename: Florence
authors.initials: F
authors.lastname: Baudraz-Rosselet
authors.forename: Maxime
authors.initials: M
authors.lastname: Vernez
authors.forename: Phillip
authors.initials: P
authors.lastname: Spring
authors.forename: Olympia
authors.initials: O
authors.lastname: Bontems
authors.forename: Marina
authors.initials: M
authors.lastname: Fratti
authors.forename: Michel
authors.initials: M
authors.lastname: Monod
mesh_terms: D000164:Acremonium / Q000187:drug effects; D000328:Adult; D000368:Aged; D000666:Amphotericin B / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000627:therapeutic use*; D001228:Aspergillosis / Q000188:drug therapy; D005260:Female; D060585:Fusariosis / Q000188:drug therapy; D006229:Hand Dermatoses / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D008875:Middle Aged; D014009:Onychomycosis / Q000188:drug therapy* / Q000382:microbiology; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents; D000666:Amphotericin B