Originally Posted by magda66
your advice and experience would be greatly appreciated here
i saw a 54 year old man for the first time recently who is awaiting a lung transplant.
c/o chronic onychomycosis of l 1st whihc he has treated with several oral and topical treatments over the years.
a couple of patient told me that they have been recommended vicks by their gp.i hadn't come across it before
i have looked for evidence and i hope the attchment works (i haven't tried it before here).
i can't see how it would do any harm but wondered whether anybody has used it successfully as he finds it difficuylt now to get to his feet but his wife would be willing to help.
The Derby et al
paper you attached was discussed here
In this pilot study, Vicks VapoRub seemed to have some clinical effect in treating onychomycosis, particularly when C. parapsilosis and T. mentagrophytes were the infecting organisms.
Nice. Particularly when Trichophyton rubrum dermatophytes are the most common pathogen in OM
Note that only 4 out of the 18 participants showed complete clinical and mycological cure and none of those 4 had tested positive for T rubrum prior
to the treatment!
This is my favourite bit;
Regardless of clinical effect, participants were highly satisfied with the simple, innocuous treatment strategy of once-daily application of Vicks vapoRub to the affected nail......... Future studies are required for proof of efficacy and better delineation of treatment effects.
Right. So, clinical outcomes aren`t important, as long as the tx is simple and innocuous
If your pt did not respond well to oral and topical anti-fungals, it may be worth suggesting laser treatment or even total avulsion. I would imagine that his immune system is pretty compromised if he is waiting for a lung transplant, so he will be susceptible to a host of infections, including tinea.