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首页> 外文期刊>Journal of drugs in dermatology: JDD >Efinaconazole 10% and Tavaborole 5% Penetrate Across Poly-ureaurethane 16%: Results of In Vitro Release Testing and Clinical Implications of Onychodystrophy in Onychomycosis
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Efinaconazole 10% and Tavaborole 5% Penetrate Across Poly-ureaurethane 16%: Results of In Vitro Release Testing and Clinical Implications of Onychodystrophy in Onychomycosis

机译：Efinaconazole 10％和Tavaborole 5％渗透到聚脲尿烷中16％：甲癣的体外释放测试结果和甲状营养不良的临床意义

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Background: Poly-ureaurethane has been previously described for the management of dry, brittle, and in general, dystrophic nails. The polymer yields a waterproof, breathable barrier to protect the nail plate and prevent further damage to the nail, while regulating transonychial water loss (TOWL). Because nail dystrophy and dessication are contributing factors to onychomycosis, a barrier that protects the nail but also allows a topical antifungal to permeate its shield is potentially an advantageous combination. Oral antifungals such as terbinafine, itraconazole, and fluconazole, as well as the newer topical antifungals efinaconazole and tavaborole (although formulated to penetrate the nail unit and work with the porosity and inherent electrical charge of the nail plate), do not take into account nail damage that has been created from years of harboring a dermatophyte infection. Up to 50% of cases presumed to be onychomycosis are in fact onychodystrophy without fungal infection, and laboratory testing for fungus should be obtained prior to initiating antifungal treatment. Whether a nail has onychomycosis, or onychodystrophy due to other causes, barrier function and structural integrity are compromised in diseased nails, and should be addressed. A poly-ureaurethane barrier that protects against wetting/drying, fungal reservoirs, and microtrauma, followed by the addition of oral or topical antifungals after laboratory fungal confirmation may optimize outcomes in the treatment of onychomycosis.
机译：背景：先前已经描述了聚脲聚氨酯用于处理干燥，易碎以及一般来说营养不良的指甲。该聚合物可产生防水，透气的屏障，以保护指甲板并防止对指甲的进一步损害，同时调节经甲骨膜间的水分流失（TOWL）。由于指甲营养不良和干燥是甲癣的促成因素，因此保护指甲但还允许局部抗真菌剂渗透其护盾的屏障可能是一种有利的组合。口服抗真菌药，例如特比萘芬，伊曲康唑和氟康唑，以及较新的局部用抗真菌药efinaconazole和tavaborole（尽管可穿透指甲单元并与指甲板的孔隙率和固有电荷协同工作），但未考虑指甲多年以来一直存在皮肤真菌感染而造成的损害。实际上，多达50％的被认为是灰指甲病的病例是灰指甲营养不良而没有真菌感染，因此应在开始抗真菌治疗之前对真菌进行实验室检查。指甲是否由于其他原因而患有甲癣，或甲癣性营养不良，患病指甲的屏障功能和结构完整性会受到损害，应予以解决。防止尿素变干/变干，真菌储库和微创伤的聚脲氨基甲酸酯屏障，随后在实验室真菌确认后再添加口服或局部抗真菌剂，可能会优化灰指甲的治疗效果。

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