Abstract
Objective : The objective of this study was to investigate the effectiveness of Onychomycosis Foot Care Therapy (OFT) in a multidisciplinary collaboration to improve tinea pedis thickened nails in diabetic patients.
Methods : A multicenter non-randomized prospective comparative study. The subjects were patients with type 1 or type 2 diabetes (mean age±SD : 72.1±12.4) with onychomycosis in a hospital, clinic, home-visit nursing facility, or nursing home who consented to the study. They were divided into an OFT group (Cosme Soda Pro, grinding, nail groove cleaning, Efinaconazole, Hirudoid, and foot pressure point massaging) and a control group (foot bath, tinea medication other than Efinaconazole, Hirudoid, and foot pressure point massaging). Primary outcomes were infected area every three months up to one year and presence of Trichophyton after one year. Secondary outcomes were new nail growth, nail thickness and pulse rate.
Results : The analysis included 122 participants (61 in each group). The median area of infection improved from 100% at baseline to 70% at 3 months and 33.0% at 1 year in the OFT group, and from 100% at baseline to 80.3% at 6 months and 75.0% at 1 year in the control group. Cases negative for Trichophyton by direct KOH microscopic examination at 1 year were 62.3% in the OFT group and 0% in the control group.
Conclusion : The OFT group showed a trend toward earlier reduction of infected area and more cases of negative for Trichophyton. The results suggest that continued multidisciplinary foot care may be useful in the treatment of severe onychomycosis in diabetic patients.
