KẾT QUẢ ĐIỀU TRỊ NẤM MÓNG BẰNG UỐNG ITRACONAZOL LIỀU XUNG TẠI BỆNH VIỆN DA LIỄU HÀ NỘI NĂM 2024

Abstract

Objective: To evaluate the treatment outcomes of onychomycosis with pulse itraconazole at Hanoi Dermatology Hospital in 2024. Subjects and Methods: A non-controlled clinical trial with before–after comparison was conducted on 40 patients with confirmed onychomycosis at Hanoi Dermatology Hospital from April to October 2024. Results: Among 40 patients, 28 with fingernail onychomycosis received a 2-month pulse itraconazole regimen, while 12 with toenail or both fingernail and toenail onychomycosis received a 3-month regimen. In the group with dermatophyte fingernail infection, the mean OSI score decreased from 18.4 ± 5.1 before treatment to 13.1 ± 5.4 after 1 month, and 6.6 ± 5.6 after 2 months (p < 0.05 at each time point). In the group with yeast fingernail infection, the mean OSI score decreased significantly from 17.7 ± 3.5 before treatment to 12.2 ± 4.1 after 1 month and 5.9 ± 5.6 after 2 months (p < 0.05). There was no statistically significant difference in OSI reduction between dermatophyte and yeast groups (p > 0.05). The clinical cure rate for fingernail onychomycosis was 19%, while mycological cure was 85.7%. For toenail onychomycosis, the mean OSI score declined from 20.1 ± 5.8 at baseline to 15.9 ± 2.2 after 1 month, 10.3 ± 2.5 after 2 months, and 4.7 ± 3.1 after 3 months (p < 0.05 at each time point). The clinical cure rate for toenail onychomycosis was 46.3%, and the mycological cure rate was 75%. Conclusion: Pulse itraconazole demonstrated good efficacy in treating moderate to severe onychomycosis, with significant OSI reduction for both fingernail and toenail infections over time. Improvement in OSI did not differ significantly between yeast and dermatophyte infections. Adverse effects were rare, usually mild, and self-limiting without additional treatment.