Nail fungal infections : current topical treatments

Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, Universidade de Lisboa, Faculdade de Farmácia, 2015Onychomycosis is a nail fungal disease that causes a great concern because of the disfiguring appearance of the nails. This disease has a high incidence (from 14 to 23 %) within the general population, especially among older persons, and presents several complications such as cellulitis, bacterial infection, pain, and extensive dermatophytic infections. Given the potential implications on the physical and mental health of the patients, it is fundamental a rigorous clinical management of onychomycosis. Currently, the treatment options include the use of oral and topical drugs. The topical formulations avoid the oral toxicity of the anti-fungal. However, these treatments are only recommended for mild to moderate cases, due to their limited effectiveness related to minimal drug permeability through the nail plate. Due to these constraints, the development of this type of therapeutic drugs remains a challenge. The present work is a review describing the current knowledge in the field of topical therapeutics for the management of onychomycosis. The anatomy of the nail, the classification of onychomycosis, the formulations designed for nail application and the approaches used to enhance the topical bioavailability of the drugs, across the nail are among the discussed topics. Furthermore, this revision presents a compilation of the main current topical treatments, including those recently available, and their advantages compared with the oral treatments