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July 3, 1996

New Drugs for the Nail Fungus Prevalent in Elderly

JAMA. 1996;276(1):12-13. doi:10.1001/jama.1996.03540010014007

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FOR AT LEAST 2 decades, the ubiquitous fingernail and toenail fungal disease onychomycosis has frustrated and discouraged physicians and patients because of a lack of effective treatment.

During this same period, fungal nail disease has been on the rise, particularly among older Americans. A new study from Case Western Reserve University School of Medicine, Cleveland, Ohio, has found that prevalence rates have increased threefold to fourfold compared with rates found by the US National Health and Nutrition Examination Survey (NHANES I) about 20 years ago. The new study showed increasing prevalence with advancing age. More than 48% of patients 70 years of age and older had onychomycosis. About 32% of those from 60 to 70 years of age were afflicted.

"I used to spend more time talking patients out of treatment than I would discussing treatment options because there were no good options," said Boni E. Elewski, MD, who is