Implicación del engrosamiento ungueal en el tratamiento de la onicomicosis del pie: revisión bibliográfica sobre su impacto en la eficacia terapéutica

Onichomycosis is a fungal infection, usually caused by dermatophytes, that triggers an inflammatory response in the nail bed. This leads to excessive keratin production, which accumulates and thickens the nail. This literature review focuses on information on nail bed keratinization in onichomycosis caused by dermatophytes and evidence of protocols using urea as a keratolytic to treat subungual keratosis. This study uses a qualitative approach and is a documentary – style research project using non – probability criteria or purposive sampling. A systematic search was conducted for scientific articles addressing this issue, using search engines such as Cochrane, PubMed, ScienceDirect and Scopus. Ten epidemiological studies demonstrated that onychomycosis is caused by dermatophytes in 80% to 90% of cases, with Trichophyton rubrum being the most common agent. Eigth studies have confirmed the efficacy of terbinafine as an antifungal; six studies mention the effectiveness of 30% or 40% urea as a keratolytic agent, which facilitates the penetration of topical antifungals; and four studies indicate the clinical repercussions, such as pain, aesthetic effects due to nail deformity, and functional limitations in mobility caused by pain.