medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2022-27-7-10medalphabet-2858Research ArticleОБЗОР ЛИТЕРАТУРЫАппаратные методы лечения онихомикозов (обзор литературы)Overview of hardware methods of treatment of onychomycosis (literature review)https://orcid.org/0000-0001-7648-4310АрабаджянМ. И.ArabadzhyanM. I.

 Арабаджян Мария Игоревна, врач-дерматовенеролог, аспирант кафедры дерматовенерологии и косметологии

Москва

Arabadzhyan Maria I., dermatovenereologist, post-graduate student of Deptof Dermatovenereology and Cosmetology 

 Moscow 

arabadzhyan@bk.ruhttps://orcid.org/0000-0003-1911-6743МайоровР. Ю.MayorovR. Yu.

Майоров Роман Юрьевич, врач-дерматовенеролог, аспирант кафедры дерматовенерологии и косметологии

Москва

Mayorov Roman Yu., dermatovenereologist, post-graduate student of Deptof Dermatovenereology and Cosmetology 

 Moscow 

ФГБУ ДПО «Центральная государственная медицинская академия» Управления делами Президента Российской ФедерацииРоссияCentral State Medical AcademyRussian Federation202227112022127Дерматология (2)710Copyright © Арабаджян М.И., Майоров Р.Ю., 20222022Арабаджян М.И., Майоров Р.Ю.Arabadzhyan M.I., Mayorov R.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/2858

Введение. Лечение грибковой инфекции ногтевых пластин сопряжено с рядом сложностей, таких как завышенные ожидания, низкая комплаентность пациента к длительной терапии, нерациональный подбор противогрибковых препаратов и, как следствие, развитие резистентности. На данный момент применяется большое количество аппаратных методов лечения онихомикоза, которые могут значительно ускорить выздоровление и повысить эффективность терапии.Обсуждение. В статье описаны такие методы физиотерапевтического лечения грибковой инфекции ногтей, как лазерные технологии, низкотемпературная плазма, фотодинамическая терапия, ионофорез, ультразвук, ультратонотерапия. Часть из них способствуют непосредственно элиминации микотического агента из пораженных тканей, другие позволяют совершенствовать процесс введения противогрибковых препаратов в толщу ногтевой пластины и ногтевое ложе. Лазерные технологии позволяют комбинировать эти патогенетически значимые механизмы воздействия на заболевание, что значительно расширяет возможность их применения.Заключение. На данный момент, несмотря на большое разнообразие методов и схем терапии онихомикозов, аппаратные методики являются перспективным полем для дальнейших исследований. Исходя из анализа отечественной и зарубежной литературы ни один метод не может быть признан универсальным и применяться как монотерапия. Однако комбинация медикаментозной терапии и аппаратных способов лечения может давать более успешные результаты как в плане терапевтической эффективности, так и в отношении противорецидивных ожиданий. Необходимо разрабатывать более четкие протоколы применения физиотерапевтических методик, чтобы повысить результативность ведения пациентов, страдающих поражением ногтевых пластин грибковой инфекцией.

Introduction. Treatment of fungal infection of nail plates is associated with a number of difficulties, such as high expectations, low patient compliance to long-term therapy, irrational selection of antifungal drugs and, as a consequence, the development of resistance. Currently, there are many hardware methods of treating onychomycosis, which can significantly accelerate recovery and increase the effectiveness of therapy. Discussion. The article describes such methods of physiotherapeutic treatment of fungal nail infection as laser technology, low-temperature plasma, photodynamic therapy, iontophoresis, ultrasound, ultratonotherapy. Some of them contribute directly to the elimination of the mycotic agent from the affected tissues; others allow improving the process of introducing antifungal drugs into the thickness of the nail plate and nail bed. Laser technologies make it possible to combine these pathogenetically significant mechanisms of influence on the disease, which considerably expands the possibility of their use.Conclusions. At the present, despite the wide variety of methods and treatment regimens for onychomycosis, hardware techniques are a promising field for further research. Based on the analysis of domestic and foreign literature, there is no method, which we can use as monotherapy. However, a combination of drug therapy and hardware methods of treatment can give successful results both in terms of therapeutic efficacy and in terms of anti-relapse expectations. It is necessary to develop precise protocols for the use of physiotherapeutic techniques in order to increase the effectiveness of the management of patients suffering from fungal infection of the nail plates.

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The authors declare that there are no conflicts of interest present.