Factors influencing cure rates of non-dermatophyte mold and Candida onychomycosis: analysis of outcomes in 81 patients who completed treatment.
OBJECTIVE
Onychomycosis shows a poor response to current topical, oral, or device-related antifungal therapies. The aim of this study was to identify factors influencing the cure rates of non-dermatophyte mold and Candida onychomycosis.


METHODS
Eighty-one patients who completed treatments were divided into "cured" and "non-cured" groups. The statistical significance of differences between the two groups was studied.


RESULTS
Male gender (P < 0.01), long duration of disease before the initiation of treatment (P < 0.02), three or more infected nails (P < 0.0002), continuous exposure to water and detergents (P < 0.05), frequent exposure to mud and soil (P < 0.01), barefoot walking (P < 0.025), concomitant diabetes and hypertension (P < 0.04), eczema (P < 0.03), and associated paronychia (P < 0.01) had negative effects on cure rates of onychomycosis. Patient age, occupation, site of illness (hand, foot or big toe), type of disease (distal and lateral subungual onychomycosis, proximal subungual onychomycosis or total dystrophic onychomycosis), pathogenic fungi, and treatment modality had no statistically significant impact on cure rate.


CONCLUSIONS
To minimize the failure rate of antifungal therapies in the treatment of onychomycosis, patients are advised to start treatment as soon as possible, and to avoid predisposing factors such as exposure to water, detergents, mud and soil, and barefoot walking.
Department of Dermatology, Base Hospital Homagama, Homagama, Sri Lanka.
Ranthilaka R
RR
Ranawaka
Department of Evaluation and Research, National Institute of Health Sciences, Kalutara, Sri Lanka.
S H Padmal
http://orcid.org/0000-0002-2416-3547
SH
de Silva
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000150:complications / Q000188:drug therapy*; D002177:Candidiasis / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology; D003902:Detergents; D048909:Diabetes Complications / Q000150:complications; D004485:Eczema / Q000150:complications; D005260:Female; D005533:Foot Dermatoses / Q000188:drug therapy* / Q000382:microbiology; D060585:Fusariosis / Q000150:complications / Q000188:drug therapy*; D006229:Hand Dermatoses / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D006973:Hypertension / Q000150:complications; D017964:Itraconazole / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009281:Naphthalenes / Q000627:therapeutic use; D014009:Onychomycosis / Q000188:drug therapy* / Q000382:microbiology*; D010304:Paronychia / Q000150:complications; D012307:Risk Factors; D012987:Soil; D000077291:Terbinafine; D061665:Time-to-Treatment; D016896:Treatment Outcome; D014867:Water; D055815:Young Adult
D000935:Antifungal Agents; D003902:Detergents; D009281:Naphthalenes; D012987:Soil; D014867:Water; D017964:Itraconazole; D000077291:Terbinafine