Effects of foot care intervention including nail drilling combined with topical antifungal application in diabetic patients with onychomycosis
Effects of foot care intervention including nail drilling combined with topical antifungal application in diabetic patients with onychomycosis
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DOI：
10.1111/j.1346-8138.2007.00310.x
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发表时间：
2007-07-01
影响因子：
3.1
通讯作者：
Kubota, Minoru
中科院分区：
文献类型：
--
作者：
Sumikawa, Masuko;Egawa, Takako;Kubota, Minoru
我们对24例未接受口服抗真菌药物治疗的糖尿病甲癣患者进行为期6个月或更长时间的定期足部护理干预，包括指甲钻孔联合局部抗真菌应用，并评估其效果。甲真菌病类型为浅表性白色甲真菌病（SWO） 8例，远外侧甲下甲真菌病（DLSO） 16例。根据甲真菌病评分临床指数（SCIO）评价甲真菌病状态。8例SWO患者中，无甲真菌病情恶化，2例在干预开始6个月后治愈，2例在干预开始1年后治愈（共4例，50%）。DILSO患者干预前的SCIO评分为18.1 +/- 6.5，干预6个月后显著下降至14.6 +/- 6.6。在我们能够连续随访1年的12例患者中，SCIO评分也较干预前显著下降。因此，足部护理干预，包括指甲钻孔结合局部抗真菌应用，对部分SWO患者的甲真菌病有一定的治疗效果。此外，干预提高了患者的足部护理意识，具有教育效果。因此，包括钻甲在内的足部护理干预可能是有用的。
We performed periodical foot care intervention including nail drilling combined with topical antifungal application for 6 months or more in 24 diabetic patients with onychomycosis who were not receiving oral antifungals, and evaluated its effects. The type of onychomycosis was superficial white onychomycosis (SWO) in eight patients, and distal-lateral subungual onychomycosis (DLSO) in 16. The state of onychomycosis was evaluated according to the Scoring Clinical Index for Onychomycosis (SCIO). Of the eight patients with SWO, none showed aggravation of the onychomycosis state, and two were cured 6 months after the initiation of intervention and two after 1 year (total of four patients, 50%). In the patients with DILSO, the SCIO score was 18.1 +/- 6.5 before intervention but significantly decreased to 14.6 +/- 6.6 6 months after intervention. In 12 patients who we were able to consecutively follow up for 1 year, the SCIO score also significantly decreased compared with the score before intervention. Thus, foot care intervention including nail drilling combined with topical antifungal application had effects on onychomycosis and achieved cure in some patients with SWO. In addition, intervention increased patients' awareness of foot care, showing educational effects. Therefore, foot care intervention including nail drilling may be useful.