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Surgery of the Foot
Published in Timothy W R Briggs, Jonathan Miles, William Aston, Heledd Havard, Daud TS Chou, Operative Orthopaedics, 2020
Yaser Ghani, Simon Clint, Nicholas Cullen
All blood is carefully cleared from the field and all exposed skin protected with petroleum jelly. A cotton bud is soaked in phenol and inserted along the exposed nail bed, under the ungual fold, and left for 60 seconds. This process is repeated once more then the whole area irrigated with copious amounts of saline. The tourniquet is released and a toe dressing applied.
Topical Products Applied to the Nail
Published in Heather A.E. Benson, Michael S. Roberts, Vânia Rodrigues Leite-Silva, Kenneth A. Walters, Cosmetic Formulation, 2019
Apoorva Panda, Avadhesh Kushwaha, H.N. Shivakumar, S. Narasimha Murthy
Antifungal drugs are used via both oral and systemic routes of administration to eradicate fungal infections of the nail. Antifungal drugs administered orally as tablets or capsules constitute the conventional mode of treatment. The drugs used in treating ungual diseases include itraconazole, griseofulvin, ketoconazole, fluconazole and terbinafine (Kushwaha et al., 2015). Most of the antifungals act by inhibiting the synthesis of ergosterol, an important constituent of fungal cell membrane. The disadvantages associated with oral therapy are low bioavailability due to poor drug solubility that could eventually lead to poor drug distribution to the infected nails. Owing to the poor distribution to the infected sites, oral treatment invariably warrants long treatment periods. Moreover, chronic use of oral antifungal drugs could cause serious side effects affecting the liver, cardiovascular system and the gastrointestinal tract (Sheehan et al., 1999 ; Shivakumar et al., 2012).
Topical Formulations for Onychomycosis: A Review
Published in Andreia Ascenso, Sandra Simões, Helena Ribeiro, Carrier-Mediated Dermal Delivery, 2017
Barbara S. Gregorí Valdes, Carolina de Carvalho Moore Vilela, Andreia Ascenso, Joao Moura Bordado, Helena Ribeiro
Chemical enhancement of ungual drug delivery can be also useful. This type of enhancement is cheaper, easier to apply, and can be performed by the patient before or concomitantly with drug application. It focuses on breaking chemical and physical bonds that maintain the integrity of the nail plate keratin. Targets for ungual chemical penetration enhancers are disulfide, peptide, hydrogen, and polar bonds. Chemical enhancers are classified according to the targeted bond and respective mechanism [40].
Biomarkers of disease in human nails: a comprehensive review
Published in Critical Reviews in Clinical Laboratory Sciences, 2022
Sarahi Jaramillo Ortiz, Michael Howsam, Elisabeth H. van Aken, Joris R. Delanghe, Eric Boulanger, Frédéric J. Tessier
Given the accuracy with which Se in nails can be determined, ungual Se is considered a proven means of assessing Se homeostasis, an indicator of the potential risks or benefits of supradietary Se supplementation, and by extension may serve as a biomarker for assessing both the risk and prognosis of several types of cancer. Nevertheless, this relationship is far from straightforward and Se concentrations are generally within a small range, with significant differences in relative risk often being reported only between the highest and lowest categories of Se concentrations. A recent study by Outzen and colleagues [80] bears witness to this complexity of the relationship between Se homeostasis and risk of disease. They examined selenoprotein levels in parallel with toenail Se in a nested case-control study of prostate cancer (993 case-control pairs) in a cohort similar to that of Geybel and colleagues [78]. In contrast to the Dutch study, however, they reported no association between circulating selenoprotein or ungual Se levels and risk of advanced, high-grade, or advanced-stage prostate cancer.
A novel technique to evaluate nail softening effects of different urea formulations
Published in Pharmaceutical Development and Technology, 2021
Hiep X. Nguyen, Yujin Kim, Tejas D. Kekatpure, Emily Lesica, Ajay K. Banga
The alteration in nail physical properties, i.e., nail swelling, has been used to screen formulations to select and optimize ungual penetration enhancers. Upon exposure to topical products, the nail was found swellable and the swelling extent was positively correlated to the nail permeability (Khengar et al. 2007). Measurement of nail thickness has been a conventional method to evaluate the hydration level of nail. The results of nail thickness measurements depended on the applied force and the measuring length of the micrometer (Vejnovic et al. 2010). In this study, we observed a swelling behavior or an increase in the thickness of bovine hoof membrane after the hydration study in vitro. Thus, we examined any possible correlation between the alteration to the membrane’s thickness and its softness. Topical formulations with the same urea concentration (4x, % w/w) were employed in this study. In general, the membrane absorbed more water and swelled thicker as the study duration increased from 10 to 18 and 24 h (Figure 6). After 10 h study, the membrane swelled differently among the groups with an increase of 4.28 ± 2.52% for 4xU-O-N2 and 0.00 ± 0.00% for 4xU-C-S1. An insignificant change in the membrane’s thickness was obtained when the study extended from 18 to 24 h: 8.13 ± 1.85% to 7.87 ± 1.49% for 4xU-O-N1; 4.69 ± 4.69% to 8.57 ± 2.02% for 4xU-O-N2; and 9.26 ± 3.23% to 7.09 ± 3.45% for 4xU-C-S1. The same urea concentration in various formulations was found to cause a marked difference in the membrane’s thickness. The inconsistent results in this study suggested that the increase in the thickness could be a poor indicator of the hydration level or the softness of the membrane.
Fractional carbon dioxide laser assisted delivery of topical tazarotene versus topical tioconazole in the treatment of onychomycosis
Published in Journal of Dermatological Treatment, 2019
Essam Bakr Abd El-Aal, Hamed Mohamed Abdo, Shady Mahmoud Ibrahim, Mostafa Taha Eldestawy
Onychomycosis has worldwide distribution and is estimated to affect approximately 2%–10% of the general adult population in the developed countries. Onychomycosis represents up to 50% of all ungual pathologies; high prevalence of the disease together with the limited efficacy of conventional therapies has stimulated the development of new and more effective approaches in treating the disease (3).