Hepatic Transaminases Evaluation in Patients with Onychomycosis Treated with Oral Antifungals: A Retrospective Study with 229 Patients

In a real-world tertiary hospital setting, where most patients carried multiple comorbidities and were on continuous medications, oral antifungals for onychomycosis demonstrated a reassuring hepatic safety profile. The low incidence of enzyme alterations, all reversible after drug withdrawal, supports the continued use of systemic therapy in appropriately selected patients, reinforcing that comorbidities alone should not preclude oral antifungal treatment when clinically indicated.