{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T02:06:12Z","timestamp":1777514772672,"version":"3.51.4"},"reference-count":23,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2015,4,9]],"date-time":"2015-04-09T00:00:00Z","timestamp":1428537600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Cutan Med Surg"],"published-print":{"date-parts":[[2015,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Onychomycosis is a difficult-to-treat infection whose current treatment paradigm relies primarily on oral antifungals. The emergence of new topical drugs broadens the therapeutic options and prompts a re-evaluation of the current Canadian treatment strategy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To define a patient-centred Canadian treatment strategy for onychomycosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>An expert panel of doctors who treat onychomycosis was convened. A systematic review of the literature on treatments for onychomycosis was conducted. Based on the results, a survey was designed to determine a consensus treatment system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>First-line therapy should be selected based on nail plate involvement, with terbinafine for severe onychomycosis (&gt;60% involvement), terbinafine or efinaconazole for moderate onychomycosis (20%-60% involvement), and efinaconazole for mild onychomycosis (&lt;20% involvement). Comorbidities, patient preference and adherence, or nail thickness may result in the use of alternative oral or topical antifungals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>These guidelines allow healthcare providers and patients to make informed choices about preventing and treating onychomycosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1203475415581310","type":"journal-article","created":{"date-parts":[[2015,4,9]],"date-time":"2015-04-09T22:12:19Z","timestamp":1428617539000},"page":"440-449","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":15,"title":["Toenail Onychomycosis\u2014A Canadian Approach With a New Transungual Treatment"],"prefix":"10.1177","volume":"19","author":[{"given":"Aditya K.","family":"Gupta","sequence":"first","affiliation":[{"name":"University of Toronto, Toronto, ON, Canada, & Mediprobe Research Inc, London, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. Gary","family":"Sibbald","sequence":"additional","affiliation":[{"name":"University of Toronto, Mississauga, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anneke","family":"Andriessen","sequence":"additional","affiliation":[{"name":"Malden and UMC St Radboud Nijmegen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Belley","sequence":"additional","affiliation":[{"name":"D\u00e9partement de M\u00e9decine Familiale et, M\u00e9decine d\u2019urgence, Facult\u00e9 de M\u00e9decine de l\u2019Universit\u00e9 Laval, Qu\u00e9bec, QC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan","family":"Boroditsky","sequence":"additional","affiliation":[{"name":"Vancouver General Hospital, Vancouver, BC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariam","family":"Botros","sequence":"additional","affiliation":[{"name":"Women\u2019s College Hospital, Toronto, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Chelin","sequence":"additional","affiliation":[{"name":"FAAFAS, Toronto, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wayne","family":"Gulliver","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Memorial University, St John, NF, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Keast","sequence":"additional","affiliation":[{"name":"General Practitioner, London, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mani","family":"Raman","sequence":"additional","affiliation":[{"name":"FRCPC, Toronto, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2015,4,9]]},"reference":[{"key":"bibr1-1203475415581310","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1972.01620050069017"},{"key":"bibr2-1203475415581310","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468-3083.2000.00124.x"},{"key":"bibr3-1203475415581310","doi-asserted-by":"publisher","DOI":"10.1016\/j.clindermatol.2009.12.006"},{"key":"bibr4-1203475415581310","doi-asserted-by":"publisher","DOI":"10.4103\/0255-0857.40522"},{"key":"bibr5-1203475415581310","doi-asserted-by":"publisher","DOI":"10.2165\/11592120-000000000-00000"},{"key":"bibr6-1203475415581310","doi-asserted-by":"publisher","DOI":"10.2310\/7750.2006.00054"},{"key":"bibr7-1203475415581310","doi-asserted-by":"publisher","DOI":"10.1080\/09546630701657187"},{"key":"bibr8-1203475415581310","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2005.01284.x"},{"key":"bibr9-1203475415581310","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2005.01282.x"},{"key":"bibr10-1203475415581310","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2011.02.038"},{"key":"bibr11-1203475415581310","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-59745-325-7_2"},{"key":"bibr12-1203475415581310","unstructured":"Valeant Canada LP. 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