**2.3 Treatment of dermatomycosis**

There are many antifungal drugs, allowing for treatment dermatomycoses effectively.

These drugs can be divided to several groups :


The mechanism of action of antifungal drugs is based on disruption of a fungal cell membrane or inhibition or disruption of DNA or RNA synthesis or inhibition of egrosterole synthesis in fungal cells.

Antifungal therapy should be selected to the type of dermatomycosis, some of them can be treated topically, others require systemic treatment. Sometimes, when fungal infection is difficult to treat, both of these therapies should be involved.

Topical antifungal therapy is often the only procedure in the superficial mycoses of skin, it is decisive for the effectiveness of therapy. In cases of extensive and chronic superficial fungal infections of the scalp and nails, topical treatment is usually an essential element of combined therapy, shortening its duration and improves the treatment results.

The main indications for oral antifungal agents include the following infections :

Fungal infections of nails and scalp

36 Epidemiology Insights

There are many antifungal drugs, allowing for treatment dermatomycoses effectively.

a. Azole drugs of the 1st generation - Chlormidazole, Clotrimazole, Miconazole, Econazole,

c. Azole drugs of the 3rd generation – Itraconazole, Fluconazole, Voriconazole, Posaconazole

The mechanism of action of antifungal drugs is based on disruption of a fungal cell membrane or inhibition or disruption of DNA or RNA synthesis or inhibition of egrosterole

Antifungal therapy should be selected to the type of dermatomycosis, some of them can be treated topically, others require systemic treatment. Sometimes, when fungal infection is

**2.3 Treatment of dermatomycosis** 

 Antifungal antiseptics: 1. Iodine compounds 2. Phenol derrivates

3. Sulphur and its derrivates

9. Heavy metals compounds

11. Quinoline derrivates 12. Benzimidazole derrivates Antifungal antibiotics:

2. Imidazole derrivates:

synthesis in fungal cells.

6. Organic acids and their derrivates 7. Derrivates of unsaturated fatty acids

10. Quaternary ammonium hydroxides

1. Polyene antibiotics (Natamycin) 2. Non-polyene antibiotcs (Gryzeofulvin)

Antifungal chemioterapeutics :

1. Fluorpirimidine derrivates - flucytosine

Izoconazole, Tioconazole, Bifonazole b. Azole drugs of the 2nd generation - Ketoconazole

3. Allyloamin derrivates - Naftifine, Terbinafine 4. Morpholine derrivates - Amorpholine 5. Pyridone derrivates - Cyclopirox

difficult to treat, both of these therapies should be involved.

4. Alcohol 5. Inorganic acids

8. Aniline dyes

These drugs can be divided to several groups :

feet. It is revealed by the appearance of a typical erythematous lesions associated with exfoliation and itching, which spread on the upper surface of the thighs and crotch. *Tinea unguium*, *Onychomycosis* – dermatophyte infection of the nail plates. Mostly caused by antropophilic and very rarely by geophilic species. Changes within nail plates begin on free edge of nail and can cause excessive callus and fragility, appearance of grooves and fractures on surface of nail, the most often nail plates are turning yellow. Infected, untreated nails undergo gradually diminishing. Toenails are more often infected than fingernails. Fungal infection of toenails is often a result of athlete`s foot.


To effectively treat fungal infections following conditions should be also applied:


After complete cure of fungal infection, the physician should inform the patient about the the principles of prevention. This is especially important for onychomycosis, because these infections are often recurrent and chronic. For this purpose, patient should frequently disinfect shoes, wear cotton socks and avoid places with high humidity such as saunas, steam baths or swimming pools (Adamski & Batura-Gabryel, 2007).
