Keys To Managing Severe Onychomycosis
Gupta and Simpson report that device-based therapeutic options for onychomycosis are expanding more rapidly than pharmacotherapy. Photodynamic therapy, iontophoresis and laser therapy have shown positive initial results, but randomized controlled trials are necessary to determine the long-term success of any of these devices.42
Despite the advances in oral, topical and now device-based therapies, manual and electric debridement remains the most commonly employed treatments for severe onychomycosis.43 Better benchmarks for clinical success may be improved with quality of life surveys and reduction in validated severity scores. These measurements may be more relevant to patients than complete mycological cures for a typically chronic and recurrent disease.
Dr. Bodman is an Associate Professor at the Kent State University College of Podiatric Medicine. He is a Diplomate of the American Board of Podiatric Medicine. Dr. Bodman is in private practice in Ohio.