Treatment for Onychomycosis of Fingernail and Tinea Corporis in Female Patients

Recommended Treatment Regimen

The British Association of Dermatologists recommends oral terbinafine 250mg once daily for 6 weeks as the first-line treatment for fingernail onychomycosis due to its superior efficacy and tolerability 1
Terbinafine has demonstrated higher mycological cure rates (80-90% for fingernail infections) compared to other antifungals 2
The British Association of Dermatologists guidelines state that terbinafine is superior to itraconazole both in vitro and in vivo for dermatophyte onychomycosis and should be considered the first-line treatment 4

If terbinafine is contraindicated, itraconazole is the next best alternative, with a recommended dosage of 200mg daily for 12 weeks continuously, or pulse therapy at 400mg daily for 1 week per month for 2 pulses 1
Itraconazole is particularly effective for Candida infections of the nail plate 5

Baseline liver function tests are recommended in patients with a history of heavy alcohol consumption, hepatitis or other liver disease, or hematological abnormalities 4
Monitor for side effects, including gastrointestinal complaints, taste disturbance, and skin reactions 1
Contraindications for terbinafine include active or chronic liver disease 4

Re-evaluate patients 3-6 months after treatment initiation 1
In cases of treatment failure, consider poor compliance, poor drug absorption, immunosuppression, dermatophyte resistance, or subungual dermatophytoma 2, 6