title: Management of Onychomycosis in Canada in 2014.
abstract: BACKGROUND
  Onychomycosis has several clinical presentations and is caused by various infectious organisms.
  
  
  OBJECTIVE
  To provide guidance for selection of appropriate treatment.
  
  
  METHODS
  The literature on onychomycosis management was reviewed to generate an evidence-based decision tree.
  
  
  CONCLUSIONS
  Several options are available: terbinafine, itraconazole, fluconazole, ciclopirox 8% nail lacquer, efinaconazole 10% nail solution, and laser therapy. Further studies on lasers are needed before use can be recommended. Nondermatophyte molds or mixed infection can be managed with terbinafine or itraconazole with or without topicals. Itraconazole, fluconazole, and efinaconazole can be used for Candida infection. For dermatophytes, topicals can be considered for mild to moderate onychomycosis. For moderate to severe cases, any oral monotherapy can be used; however, we suggest terbinafine if there is a possibility of a drug interaction. These recommendations can be applied for all ages, immune function, or metabolic status, but proper monitoring and contraindications should be taken into consideration.
authors.affiliation: Department of Medicine, University of Toronto, Toronto, ON, and Mediprobe Research Inc., London, ON agupta@execulink.com.
authors.forename: Aditya K
authors.initials: AK
authors.lastname: Gupta
authors.affiliation: Department of Medicine, University of Toronto, Toronto, ON, and Mediprobe Research Inc., London, ON.
authors.forename: Maryse
authors.initials: M
authors.lastname: Paquet
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use; D002170:Canada; D003646:Debridement; D006801:Humans; D014009:Onychomycosis / Q000150:complications / Q000382:microbiology / Q000628:therapy*
chemical_list: D000935:Antifungal Agents