Prognostic factors for cure following treatment of onychomycosis

J Eur Acad Dermatol Venereol. 2010 Jun;24(6):679-84. doi: 10.1111/j.1468-3083.2009.03487.x. Epub 2009 Nov 19.


Objective: To examine if host baseline factors and week 24 mycology results are associated with mycological and clinical cure in patients with onychomycosis treated with oral terbinafine.

Design: Open pilot study to determine prognostic factors in the treatment of onychomycosis.

Setting: Outpatient dermatology clinic.

Patients: A total of 199 patients from the Icelandic arm of a trial comparing continuous terbinafine with intermittent terbinafine in onychomycosis were recruited for additional observation.

Main outcome measures: Mycological, clinical and complete cure of the target toenail 72 weeks after treatment was initiated.

Results: Patients with matrix involvement or slow nail growth were less likely to reach mycological, clinical and complete cure. Lateral involvement affected complete and mycological cure rates negatively. Patients with a dermatophytoma were less likely to reach mycological cure. Patients with a history of prior infection, men and older patients were less likely to reach clinical cure. Positive culture at 24 weeks affected mycological and clinical cure at 72 weeks negatively.

Limitations: Only patients treated with terbinafine were considered.

Conclusions: Several host-related factors at baseline and positive culture at 24 weeks had negative effects on cure of onychomycosis 72 weeks after treatment was initiated. This finding merits a large study on prognostic outcome factors in onychomycosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Adolescent
  • Adult
  • Aged
  • Antifungal Agents / administration & dosage
  • Antifungal Agents / therapeutic use*
  • Dose-Response Relationship, Drug
  • Female
  • Foot Dermatoses / diagnosis*
  • Foot Dermatoses / drug therapy*
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Naphthalenes / administration & dosage
  • Naphthalenes / therapeutic use*
  • Onychomycosis / diagnosis*
  • Onychomycosis / drug therapy*
  • Pilot Projects
  • Prognosis
  • Terbinafine
  • Treatment Outcome
  • Young Adult


  • Antifungal Agents
  • Naphthalenes
  • Terbinafine