Onychomycosis as a sociomedical problem: assessment of patients’ quality of life with the modified OnyCOE-T questionnaire

Onychomycosis is the most common disease of the nail apparatus in modern dermatological practice. Taking into account the high prevalence, onychomycosis should be considered as a significant sociomedical problem. Moreover, psychosocial limitations associated with onychomycosis have the potential to destructively influence the professional and social activity. Nevertheless, some clinicians tend to consider onychomycosis predominantly as a not medically significant cosmetic defect. A number of validated scales and questionnaires, which allow to objectively assess the impact of onychomycosis on the quality of life of patients as well as treatment efficacy, was developed. Objective. To evaluate the dynamics of quality of life of patients with onychomycosis before and after treatment with photodynamic therapy (PDT) using chlorin-containing photosensitizer (PS) by means of the modified OnyCOE-T questionnaire. Material and methods. In an open prospective study, 40 patients with clinically and laboratory verified onychomycosis diagnosis were examined, which were stratified into 2 groups of 20 persons. Patients in the 1st group received PDT with a derivative of chlorin e6 as a photosensitizer, in the 2nd one — combined treatment including PDT and shortened course of systemic antifungal agents. The quality of life was assessed through the modified OnyCOE-T questionnaire before and after treatment. Results. It has been shown that onychomycosis has a multifactorial effect on the quality of life of patients. It is particularly remarkable that 28 (70%) respondents noted a «severe negative impact» of the disease on the quality of life. Psychological discomfort and functional disorders were the predominant complaints. Conclusion. Despite the absence of vital threats, onychomycosis significantly reduces the quality of life of patients. It seems appropriate to intensify educative activities with regard to the prevention of mycotic infection and modern therapeutic possibilities.