Abstract

ASSESSMENT OF THE EFFECTIVENESS OF COMBINATION OF SYSTEMIC AND TOPICAL ANTIFUNGALS AGAINST MONOTHERAPY WITH EITHER ONE IN ONYCHOMYCOSIS; RISK FACTOR ASSESSMENT AND IMPACT OF PATIENT COUNSELLING ON QUALITY OF LIFE OF PATIENTS – A PILOT STUDY

Anjitha S. Kumar, Hephzeeba Joyce, Swathy S.* and Prasobh G. R.

Abstract

Background: Onychomycosis is one of the common infections which affect the daily activities and quality of life of patients. It will affect both the finger nails and toe nails. It has a major risk in the diabetic patients. Aim: To assess the effectiveness of monotherapy and combination of systemic and topical antifungals, to assess the risk factors associated with disease and to improve quality of life by patient counselling. Objectives: To assess the effectiveness of monotherapy and combination therapy, to evaluate the risk factors of disease and to evaluate the impact of patient counselling on quality of life by DLQI . Materials and Methods: A prospective observational study consisting of 20 patients with onychomycosis was conducted in the outpatient and inpatient Department of Dermatology at Cosmopolitan Hospital-Post Graduate Institute of Medical Science and Research, Thiruvananthapuram, Kerala. Patients were requested to sign the informed consent after knowing about our study using the patient information sheets. Patients who were having onychomycosis were analyzed using KOH method were included in the study. Also, the patient having onychomycosis and the history of diabetic, trauma, any nail infections were included. The age group was in between 20-80 years. Outpatients and Inpatients are selected for the study. The patients was divided into two groups, patients receiving monotherapy as Group I and patients receiving combination therapy as Group II and the KOH method was done on each individual. SCIO scoring was calculated and recorded. SCIO scoring from 1-30, the effectiveness of the treatment was obtained through this scoring method. Patient counseling was given to them using DLQI questionnaire, consisting of 10 questions and scoring range between 0-30, it was taken before and after treatment. Statistical analysis was performed using suitable computer programming. Results: The proportion of combination therapy from the paired t test was found to be p< 0.001 and the monotherapy p= 0.343. Onychomycosis was mostly affected on females (housewives), at the age group of 61-70 and DLSO type of onychomycosis was common. Most of the patients are diabetic and toe nails are affected more in such cases. Conclusion: Combination therapies are more effective than monotherapy and the quality of life of patient was improved after the patient counseling.

Keywords: Onychomycosis, KOH method, monotherapy and combination therapy, DLQI, SCIO Index.