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A recent study from Switzerland demonstrated a 25 percent increase in nail plate thickness in patients with brittle nails who received biotin supplementation. Analysis of all visits to a nail consultation practice over a six-month period revealed forty-four patients with this condition who had been prescribed the B-complex vitamin biotin. Of these, thirty-five who took daily supplementation were subjectively evaluated. Twenty-two of thirty-five (63 percent) showed clinical improvement and thirteen (37 percent) reported no change in their condition. The results of this small, retrospective study suggest a positive response to biotin in the treatment of brittle nails in some patients.

Optimal topical therapy for distal subungual onychomycosis is not available. An open-label study was performed to determine the safety and efficacy of naftifine hydrochloride (Naftin) 1 percent gel in patients with this disorder of the fingers. Ten patients with culture-proven distal subungual onychomycosis were treated twice daily for six months with naftifine hydrochloride 1 percent gel. At monthly intervals, the target nail was trimmed, the nail bed debrided, and global clinical assessment recorded. Following months three, six, and eight (two months after treatment), the target nail underwent evaluation with potassium hydroxide wet mount and fungal culture. After six months of therapy, eight of ten patients showed negative results of fungal culture and eight of ten patients showed clinical improvement. Adverse effects were minimal and included mild peeling in two patients and mild fissuring with transient fingertip numbness in one patient.

Onychomycosis is the most frequent cause of nail diseases. An open-label study has been conducted to evaluate the safety and efficacy of Fungoid Tincture, a topical antifungal agent approved by the Food and Drug Administration for the treatment of onychomycosis of the toes. Ten patients with culture-proven distal subungual onychomycosis were treated twice daily for twelve months with topical Fungoid Tincture. Another ten patients with the same condition were treated with the vehicle alone. At monthly intervals, the target nail was trimmed, the nail bed debrided, and global clinical assessment recorded. After twelve months of therapy, all patients applying Fungoid Tincture showed negative findings on fungal culture. The vehicle alone benefitted several patients, and may have antifungal activity. Adverse effects were minimal, with mild peeling occurring in seven patients and erythema noted in one.