title: Natural coniferous resin lacquer in treatment of toenail onychomycosis: an observational study.
abstract: In in vitro tests, natural coniferous resin from the Norway spruce (Picea abies) is strongly antifungal. In this observational study, we tested the clinical effectiveness of a lacquer composed of spruce resin for topical treatment of onychomycosis. Thirty-seven patients with clinical diagnosis of onychomycosis were enrolled into the study. All patients used topical resin lacquer treatment daily for 9 months. A mycological culture and potassium hydroxide (KOH) stain were done from nail samples in the beginning and in the end of the study. Treatment was considered effective, if a mycological culture was negative and there was an apparent clinical cure. At study entry, 20 patients (20/37; 54%; 95% CI: 38-70) had a positive mycological culture and/or positive KOH stain for dermatophytes. At study end, the result of 13 patients was negative (13/19; 68%; 95% CI: 48-89). In one case (1/14; 7%; 95% CI: 0-21) the mycological culture was initially negative, but it turned positive during the study period. By 14 compliant patients (14/32; 44%; 95% CI: 27-61), resin lacquer treatment was considered clinically effective: complete healing took place in three cases (9%) and partial healing in 11 cases (85%). The results indicate some evidence of clinical efficacy of the natural coniferous resin used for topical treatment of onychomycosis.
authors.affiliation: Repolar Ltd., Espoo, Finland.
authors.forename: Pentti
authors.initials: P
authors.lastname: Sipponen
authors.forename: Arno
authors.initials: A
authors.lastname: Sipponen
authors.forename: Jouni
authors.initials: J
authors.lastname: Lohi
authors.forename: Marjo
authors.initials: M
authors.lastname: Soini
authors.forename: Riikka
authors.initials: R
authors.lastname: Tapanainen
authors.forename: Janne J
authors.initials: JJ
authors.lastname: Jokinen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000737:chemistry / Q000302:isolation & purification / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006878:Hydroxides / Q000737:chemistry; D008297:Male; D008875:Middle Aged; D009262:Nails / Q000382:microbiology*; D014009:Onychomycosis / Q000188:drug therapy* / Q000473:pathology; D028222:Picea / Q000737:chemistry*; D017680:Potassium Compounds / Q000737:chemistry; D011446:Prospective Studies; D012116:Resins, Plant / Q000737:chemistry / Q000627:therapeutic use*; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014249:Trichophyton / Q000302:isolation & purification*
chemical_list: D000935:Antifungal Agents; D006878:Hydroxides; D017680:Potassium Compounds; D012116:Resins, Plant; C029943:potassium hydroxide