한국인의 손발톱진균증 환자의 역학적 조사: 다기관 연구
Epidemiologic Survey of Onychomycosis in Koreans: Multicenter Study
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초록
Background: Although there have been many studies about onychomycosis, no study about Koreans in onychomycosis has been reported in Korea. Objective: The purpose of this study was to investigate the onychomycosis in Koreans. Methods: From April, 2009, to March, 2010, 1,893 patients with onychomycosis who visited the department of dermatology at 10 university hospitals were evaluated. Results: Of 1,893 patients with onychomycosis, 93.8% were toenail onychomycosis, 2.2% fingernail onychomycosis, and 4.0% onychomycosis in both toenails and fingernails. Among the age groups, the incidence rate was highest over the sixties (35.6%). The ratio of male to female patients was 1.3:1. Distal and lateral subungual onychomycosis (80.3%) was the most common clinical type of onychomycosis. Combination therapy of oral terbinafine or itraconazole and topical amorolfine nail lacquer was most common in the treatment of onychomycosis. The most common reasons for combination therapy in onychomycosis were higher cure rate due to synergistic activity (40.2%), followed by shortened treatment duration (12.8%), patient compliance (12.3%), and prevention of recurrence and reinfection (1.7%). Conclusion: Because of the increase in onychomycosis, we suggest the need of standard treatment guidelines for Korean patients with onychomycosis.
Abstract
Background: Although there have been many studies about onychomycosis, no study about Koreans in onychomycosis has been reported in Korea. Objective: The purpose of this study was to investigate the onychomycosis in Koreans. Methods: From April, 2009, to March, 2010, 1,893 patients with onychomycosis who visited the department of dermatology at 10 university hospitals were evaluated. Results: Of 1,893 patients with onychomycosis, 93.8% were toenail onychomycosis, 2.2% fingernail onychomycosis, and 4.0% onychomycosis in both toenails and fingernails. Among the age groups, the incidence rate was highest over the sixties (35.6%). The ratio of male to female patients was 1.3:1. Distal and lateral subungual onychomycosis (80.3%) was the most common clinical type of onychomycosis. Combination therapy of oral terbinafine or itraconazole and topical amorolfine nail lacquer was most common in the treatment of onychomycosis. The most common reasons for combination therapy in onychomycosis were higher cure rate due to synergistic activity (40.2%), followed by shortened treatment duration (12.8%), patient compliance (12.3%), and prevention of recurrence and reinfection (1.7%). Conclusion: Because of the increase in onychomycosis, we suggest the need of standard treatment guidelines for Korean patients with onychomycosis.
참고문헌 (35)
- Verma S, "Superficial fungal infections: dermatophytosis, onychomycosis, tinea nigra, piedra, In derma tology in general medicine", pp.1807~1821 (2008), McGraw-Hill
- Elewski BE, "Novel treatment strategies for superficial mycoses: introduction", J Am Acad Dermatol, 40, pp.S1~S2 (1999)
- Suh MK, "Treatment and prophylaxis of onychomycosis", Korean J Med Mycol, 6, pp.140~142 (2001)
- Baran R, "A new classification of onychomycosis", Br J Dermatol, 139, pp.567~571 (1998)
- Roberts DT, "Onychomycosis. current treatment and future challenges", Br J Dermatol, 141(56), pp.1~4 (1999)
- Tosti A, "Relapses of onychomycosis after successful treatment with systemic antifungals: a three-year follow-up", Dermatology, 197, pp.162~166 (1998)
- Brautigam M, "Successful treatment of toenail onychomycosis with terbinafine and itraconazole gives long term benefits", Br Med J, 317, pp.1084~1085 (1998)
- Evans EG, "The rationale for combination therapy", J Dermatol, 145(60), pp.9~13 (2001)
- Lim SW, "features and identification of etiologic agents in onychomycosis (1999-2002)", Korean J Dermatol, 42, pp.53~60 (2004)
- 박장규, "조갑진균증의 임상적 고찰", 대한의진균학회지, 10(2), pp.46~54 (2005), 대한의진균학회1
- Lee JM, "Analysis of treatment results of patients with tinea unguium and assessment of the real effectiveness of antifungal agents and patient compliance", Korean J Dermatol, 36, pp.772~779 (1998)
- Sohn JK, "Onychomycosis in the elderly", Korean J Med Mycol, 6, pp.77~83 (2001)
- 문석기, "노인에서의 족부백선과 조갑진균증의 유병률", 대한의진균학회지, 11(3), pp.132~140 (2006), 대한의진균학회1
- 송영찬, "조갑진균증 환자 동반질환 및 병용 약물에 관한 연구", 대한의진균학회지, 12(3), pp.163~172 (2007), 대한의진균학회1
- Dogra S, "Epidemiology of onychomycosis in patients with diabetes mellitus in India", Int J Dermatol, 41, pp.647~651 (2002)
- Cathcart S, "Onychomycosis and diabetes", J Eur Acad Dermatol Venereol, 23, pp.1119~1122 (2009)
- Gupta AK, "Prevalence and epidemiology of onychomycosis in patients visiting physician's offices: a multicenter Canadian survey of 15,000 patients", J Am Acad Dermatol, 43, pp.244~248 (2000)
- Ioannidou DJ, "The epidemiology of onychomycoses in Crete, Greece, between 1992 and 2001", J Eur Acad Dermatol Venereol, 20, pp.170~174 (2006)
- Kim JA, "Clinical features and classification of nail diseases", Korean J Dermatol, 37, pp.1733~1742 (1999)
- 안효상, "한국인 손발톱진균증의 임상적 분류", 대한의진균학회지, 13(3), pp.129~137 (2008), 대한의진균학회1
- 오대헌, "선형 조갑진균증의 발생 요인과 치료 반응에 대한 연구", 대한의진균학회지, 10(1), pp.21~29 (2005), 대한의진균학회1
- 김덕한, "조갑진균증의 임상적 고찰 : 조갑진균증의 치료에 영향을 주는 인자와 그에 따른 치유율 비교", 대한의진균학회지, 10(2), pp.55~69 (2005), 대한의진균학회1
- Scher RK, "Onychomycosis: diagnosis and definition of cure", J Am Acad Dermatol, 56, pp.939~944 (2007)
- Baran R, "A randomized trial of amorolfine 5% solution nail lacquer combined with oral terbinafine compared with terbinafine alone in the treatment of dermatophytic toenail onychomycosis affecting the matrix region", Br J Dermatol, 142, pp.1177~1183 (2000)
- Baran R, "Topical amorolfine for 15 months combined with 12 weeks of oral terbinafine, a cost-effective treatment for onychomycosis", Br J Dermatol, 145(60), pp.15~19 (2001)
- Lecha M, "Amorolfine and itraconazole combination for severe toenail onychomycosis; results of an open randomized trial in Spain", Br J Dermatol, 145(60), pp.21~26 (2001)
- Rigopoulos D, "A random trial of amorolfine 5% solution nail lacquer in association with itraconazole pulse therapy compared with itraconazole alone in the treatment of Candida fingernail onychomycosis", Br J Dermatol, 149, pp.151~156 (2003)
- Flagothier C, "New insights into the effect of amorolfine nail lacquer", Mycoses, 48, pp.91~94 (2005)
- Finch JJ, "Toenail onychomycosis: current and future treatment options", Dermatol Ther, 20, pp.31~46 (2007)
- 김현철, "발톱 조갑진균증에서 항진균제 경구 치료와 국소제 병용 치료의 순응도 및 완치율 비교", 대한의진균학회지, 7(1), pp.35~41 (2002), 대한의진균학회1
- 이양원, "족부 조갑진균증 치료에서 수종 경구용 항진균제에 따른 환자 순응도에 대한 후향적 연구", 대한의진균학회지, 7(3), pp.149~154 (2002), 대한의진균학회1
- 김기홍, "대구지역 발톱 조갑진균증 환자에서 Terbinafine 연속요법과 Itraconazole 주기요법에 대한 치료완료율 비교", 대한의진균학회지, 7(4), pp.217~223 (2002), 대한의진균학회1
- 김지은, "조갑진균증 치료의 순응도와 장기적 추적 관찰", 대한의진균학회지, 8(3), pp.110~117 (2003), 대한의진균학회1
- 이양원, "조갑진균증의 치료와 환자 순응도에 대한 고찰", 대한의진균학회지, 10(3), pp.83~90 (2005), 대한의진균학회1
- 허재, "환자들이 선호하는 발톱진균증의 경구 치료법", 대한의진균학회지, 14(2), pp.79~87 (2009), 대한의진균학회1