Abstract
BACKGROUND: Onychomycosis is a chronic fungal infection of the nails of toes and fingers, with an ongoing search for appropriate and more officious treatment modalities because the currently applied regimens are far from perfect. OBJECTIVE: The objective of this study was to compare the efficacy of the combination of topical tazarotene 0.1% gel and oral fluconazole with weekly oral fluconazole monotherapy in the treatment of OM. METHODOLOGY: This quasi-experimental study was conducted over three months in the outpatient dermatology clinic of a tertiary healthcare facility in Pakistan. A total of 60 patients fulfilling the inclusion criteria were included. A detailed history, dermatological examination, and Onychomycosis Severity Index (OSI) were implemented in each patient to record the severity of their disease and treatment outcome. The patients were randomized into two groups i.e. Group A, where a weekly oral fluconazole tablet of 150mg and daily topical tazarotene 0.1% gel were administered, and Group B in which a weekly oral fluconazole tablet of 150mg alone was administered for three months each. The potassium hydroxide mounts from nail materials were performed at the end of the treatment period in all the patients. Data analysis was carried out using IBM SPSS Statistics for Windows, Version 23 (Released 2015; IBM Corp., Armonk, New York, United States). RESULTS: Of the total, 36 (60%) were male with a mean age of 46.47±10.60 years and 24 (40%) were female with a mean age of 46.08±10.16 years. Following the comparison between the two groups, the combination therapy had higher efficacy and better treatment success (70%, n=23) compared to fluconazole monotherapy (56.6%, n=17), in terms of the fall in the degree of OSI, clinical evaluation, and KOH preparation after treatment (p-value <0.001, 0.001, and 0.03, respectively). CONCLUSIONS: The efficacy of oral weekly fluconazole combined with daily topical tazarotene 0.1% gel is significantly higher than that of weekly fluconazole monotherapy in the treatment of OM.