13 responses to “Nail fungus”

  1. This is one of the most useful of these articles yet!

  2. Really appreciated the simple but effective advice about a common / difficult condition

  3. that is the most common sense approach I have seen on this topic. Thanks very much Dr Murray. Could we please hear more from this dermatologist?

  4. Great idea to get the patient to collect the clippings etc themselves at home. Great article.

  5. nice article, and great tip for taking clippings at home after shower/bathing. i am more familiar with terbinafine treatment, but good to learn about the alterantive pulse treatment with itraconazole….

  6. Helpful article
    Thank you

  7. Great article

  8. Thanx for the tips especially how to diagnose nail conditions. Clipping and making a groove in the nail are definetly worthy to try.

  9. Very helpful article!

    I wonder, Dr. Murray, how pulse dose terbinafine compares to the continuous terbinafine dosing? One of our local general surgeons uses pulsed terbinafine for onychomycosis but I have yet to find any non-anecdotal support for this strategy.


  10. Thanks for the useful information on the nail infection which is quite a challenging area to manage for patient care.

  11. For Elizabeth,
    As far as I know there are no proven advantages or substantial evidence to support a need for pulsed dosing of terbinafine. Terbinafine is a very safe drug, well tolerated and has few drug interactions. I suspect there is better compliance with daily dosing so I do not use nor recommend pulse therapy.
    Eileen Murray

  12. what is the incidence of liver disfunction with terbinifine?

  13. also, what about people who are on statins? is there a higher risk of complication with terbinafine? how often do you check liver enzymes?

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