{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T22:45:25Z","timestamp":1791499525573,"version":"4.3.4"},"reference-count":26,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,12,3]],"date-time":"2020-12-03T00:00:00Z","timestamp":1606953600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Severe onychomycosis treatment in kidney transplant recipients (KTR) is challenging because of drug interactions and adverse events. Tacrolimus remains the antirejection treatment (ART) of choice in kidney transplantation but tolerance with systemic terbinafine for the management of severe onychomycosis has not been studied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>This study illustrates severe onychomycosis management in a kidney transplantation setting and investigates systemic terbinafine tolerance profile in KTR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients\/Methods<\/jats:title><jats:p>We retrospective analysed clinical data of KTR with a confirmed diagnosis of severe onychomycosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We retrieved a total of 29 KTR with severe onychomycosis needing an oral treatment to manage onychomycosis. In 55.1% (16\/29) KTR, altered renal biological parameters or lack of guidelines to manage severe onychomycosis were the main reasons to deterring clinicians from prescribing oral treatments. 13 patients received an oral terbinafine treatment (9, 3 and 1 with a tacrolimus, cyclosporine and everolimus\u2010based ART, respectively). Clinical and biological follow\u2010up did not reveal severe drug interactions. ART blood levels showed significant variations in 2 patients without clinical consequences in renal graft. Two patients reported mild adverse events but after only one dose of terbinafine. Using an open\u2010source image analysis program, clinical evolution of onychomycosis could be retrospectively quantified and followed up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The results presented here suggest that oral terbinafine can be proposed to treat severe onychomycosis with an acceptable tolerance profile in KTR with different ART such as tacrolimus and highlight the need of multicentric studies to establish guidelines for onychomycosis treatment in KTR.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.13220","type":"journal-article","created":{"date-parts":[[2020,11,27]],"date-time":"2020-11-27T18:43:46Z","timestamp":1606502626000},"page":"309-315","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Severe onychomycosis management with oral terbinafine in a kidney transplantation setting: Clinical follow\u2010up by image analysis"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7571-9533","authenticated-orcid":false,"given":"Alicia","family":"Moreno\u2010Sabater","sequence":"first","affiliation":[{"name":"Centre d'Immunologie et des Maladies Infectieuses (CIMI\u2010Paris) Sorbonne Universit\u00e9 Inserm U1135  Paris France"},{"name":"Service de Parasitologie\u2010Mycologie AP\u2010HP H\u00f4pital Saint\u2010Antoine  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nac\u00e9ra","family":"Ouali","sequence":"additional","affiliation":[{"name":"Service d'Urgences N\u00e9phrologiques et Transplantation R\u00e9nale H\u00f4pital Tenon  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Chasset","sequence":"additional","affiliation":[{"name":"Centre d'Immunologie et des Maladies Infectieuses (CIMI\u2010Paris) Sorbonne Universit\u00e9 Inserm U1135  Paris France"},{"name":"Service de 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