Topical efinaconazole: A promising therapeutic medication for tinea unguium.

We treated tinea unguium (onychomycosis caused by dermatophytes) patients with efinaconazole 10% solution. All patients with tinea unguium who tested positive for fungi in fingernails and toenails, regardless of age or severity, were eligible for the treatment. The number of patients was 106, consisting of 43 men and 63 women with a mean age of 66.7 years. The patients were treated with efinaconazole for a mean treatment duration of 38.1 weeks. Therapeutic efficacy was rated on a 5-point scale as follows: "cured", "markedly improved", "improved", "slightly improved" or "no change". A single nail was selected in each patient as the target nail. Selected nails were the big toenails with less than 50% involvement in 25 patients, the big toenails with 50% or more involvement in 52 patients, the fingernails in 10 patients and the second to fifth toenails in 19 patients with a mean treatment duration of 43.9, 38.1, 38.7 and 33.7 weeks, respectively. All groups showed an improvement in the percentage involvement from 30.6% to 9.8%, 77.6% to 35.7%, 82.7% to 17.6% and 80.3% to 15.5%, respectively (P < 0.01). The improvement rate (i.e. percentage of those rated as improved and better) was 76.0%, 65.4%, 80.0% and 89.5%, respectively. Efinaconazole 10% topical solution is beneficial for patients, regardless of age, severity or clinical type.