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Publication
Desafios no tratamento das onicomicoses
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Advisor(s)
Abstract(s)
A unha é uma estrutura anatómica rica em queratina, responsável pela proteção, sensação e manipulação de objetos. Para além destas atribuições, a unha desempenha um papel importante na componente estética de cada pessoa. Atualmente, a contínua procura da população em melhorar a sua aparência, leva a uma maior sensibilização desta para qualquer distúrbio que possa comprometer a sua imagem.
A onicomicose é uma infeção fúngica das unhas, provocada maioritariamente por fungos capazes de invadir e proliferar em tecidos queratinizados, os fungos filamentosos dermatófitos. Como exemplo temos duas espécies do género Trichophyton, T. rubrum e T. mentagrophytes. A onicomicose é a onicopatia mais diagnosticada mundialmente e apresenta grande incidência em indivíduos com idade avançada, do sexo masculino e com comorbilidades. As principais manifestações clínicas são a descoloração e espessamento da unha, dor e desconforto. Um diagnóstico de onicomicose com observação clínica, testes micológicos e diferenciais, permite uma identificação mais pormenorizada do tipo e etiologia da infeção fúngica.
Para o tratamento da onicomicose existem terapêuticas farmacológicas e não farmacológicas. A escolha do tipo de regime deverá ter em conta as características do doente e da onicomicose.
A onicomicose é uma doença com grande impacto na saúde mental e bem-estar dos doentes. A alteração estética das unhas e a resposta lenta das terapêuticas, influencia a adesão do doente. O desenvolvimento recente de produtos tópicos não farmacológicos com efeito cosmético é uma aposta promissora.
No entanto, questiona-se se será possível aplicar este conceito nas formulações farmacêuticas tópicas de antifúngicos. Deste modo, é importante a realização de estudos que investiguem a viabilidade de um antifúngico tópico com cor.
The nail is a keratin-rich anatomical structure responsible for protecting, sensation and manipulating objects. In addition to these functions, the nail plays an important role in a person's aesthetics. Nowadays, the population's constant quest to improve appearance has led to a greater awareness of any disorders that could compromise their image. Onychomycosis is a fungal infection of the nail, most commonly caused by fungi capable of invading and multiplying in keratinised tissue, specifically filamentous dermatophytes fungi. Examples include two species of the genus Trichophyton, T. rubrum and T. mentagrophytes. Onychomycosis is the most commonly diagnosed onychopathy worldwide and has a higher incidence in older adults, males and individuals with comorbidities. The main clinical manifestations are discoloration and thickening of the nail, pain and discomfort. A diagnosis of onychomycosis, based on clinical observation, mycological tests and differential diagnostics, allows for a more detailed identification of the type and etiology of the fungal infection. For the onychomycosis’ treatment there are pharmacological and nonpharmacological therapies. The choice of therapeutic regimen is based in pacient’s and onychomycosis’ characteristics. Onychomycosis has a significant impact on the mental health and well-being of its patients. The altered appearance of the nails and the slow action of treatments, influence patient’s compliance. The recent development of non-pharmacological topical products with a cosmetic effect is a promising bet. However, it is questionable whether it is possible to apply this concept to topical pharmaceutical formulations of antifungals. Therefore, it is important to conduct studies investigating the viability of a topical antifungal with colour.
The nail is a keratin-rich anatomical structure responsible for protecting, sensation and manipulating objects. In addition to these functions, the nail plays an important role in a person's aesthetics. Nowadays, the population's constant quest to improve appearance has led to a greater awareness of any disorders that could compromise their image. Onychomycosis is a fungal infection of the nail, most commonly caused by fungi capable of invading and multiplying in keratinised tissue, specifically filamentous dermatophytes fungi. Examples include two species of the genus Trichophyton, T. rubrum and T. mentagrophytes. Onychomycosis is the most commonly diagnosed onychopathy worldwide and has a higher incidence in older adults, males and individuals with comorbidities. The main clinical manifestations are discoloration and thickening of the nail, pain and discomfort. A diagnosis of onychomycosis, based on clinical observation, mycological tests and differential diagnostics, allows for a more detailed identification of the type and etiology of the fungal infection. For the onychomycosis’ treatment there are pharmacological and nonpharmacological therapies. The choice of therapeutic regimen is based in pacient’s and onychomycosis’ characteristics. Onychomycosis has a significant impact on the mental health and well-being of its patients. The altered appearance of the nails and the slow action of treatments, influence patient’s compliance. The recent development of non-pharmacological topical products with a cosmetic effect is a promising bet. However, it is questionable whether it is possible to apply this concept to topical pharmaceutical formulations of antifungals. Therefore, it is important to conduct studies investigating the viability of a topical antifungal with colour.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Unha Onicomicose Terapêutica Estética