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New research · Dermatology
Journal of cutaneous medicine and surgery · 1w
Cohort studyJournal of cutaneous medicine and surgery · 2026

Diagnosis and Treatment of Onychomycosis in Psoriasis Patients: A Single-Center Cohort Study.

Noa Zur Aviran, Danielle Berkovich Davidson, Shany Sherman … Lev Pavlovsky
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DermatologyCohort study

Clinical improvement was more common with terbinafine than fluconazole for nail fungal infection

Diagnosis and Treatment of Onychomycosis in Psoriasis Patients: A Single-Center Cohort Study.

Noa Zur Aviran … Lev Pavlovsky
Journal of cutaneous medicine and surgery · 2026
Background

Literature on onychomycosis prevalence, causative agents, and systemic antifungal treatment efficacy in psoriasis are sparse.

Purpose

The objectives of the study were to determine onychomycosis prevalence in psoriasis patients with nail changes and to evaluate the efficacy and safety of 2 systemic antifungal treatments, terbinafine, and fluconazole.

Methods

Records from the Division of Dermatology at Rabin Medical Center (2012-2022), were retrospectively analyzed, including nail samples from consecutive psoriasis patients referred to the institutional mycological laboratory.

Results

clinical improvement was seen in far more terbinafine-treated nails than fluconazole-treated ones

70.8%
Terbinafine
40.7%
Fluconazole
More results

One hundred thirty-nine psoriasis patients with suspected onychomycosis were referred for mycological testing (46.8% female, median age 62 years), onychomycosis was diagnosed in 67.6% of cases.

Fifty-one point one percent of patients were on systemic psoriasis treatments, 60.6% of them receiving biologic therapies.

More results

Trichophyton rubrum was the most prevalent (81.3%) isolated fungi of all positive cultures.

Fifty-one patients received systemic antifungal treatment, with 47.1% receiving terbinafine and 52.9% fluconazole.

“
Conclusion

This cohort provides insights into prevalence of onychomycosis, and the efficacy and safety of systemic antifungal treatment in psoriasis patients, including patients on biologic therapies. Further prospective studies are recommended.

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