{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T08:13:22Z","timestamp":1766391202514,"version":"build-2065373602"},"reference-count":26,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2021,12,19]],"date-time":"2021-12-19T00:00:00Z","timestamp":1639872000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Government of Extremadura","award":["code CTS020, reference GR18182"],"award-info":[{"award-number":["code CTS020, reference GR18182"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Onychomycosis is the main cause of toenail disorders and is produced by a fungal infection. It is becoming more prevalent because of new lifestyles and immunosuppression statuses. The therapeutic approach to onychomycosis is under considerable study because of the lengthy treatments that require strong patient commitment, the limited efficacy of treatments, the inclusion of active substances that can be hepatotoxic and cause pharmacological interactions, and\/or the questionable efficacy of treatments due to a lack of clinical trials. This study responds to the demand for rapid treatment with minimal pharmacological interactions. Methods: The efficacy of nitric acid 60% treatment in patients with onychomycosis was monitored and studied. The antifungal efficacy of nitric acid was measured by microbiological culture before and after treatment and the clinical evolution of nail dystrophy was quantitatively measured by monitoring with the Onychomycosis Severity Index (OSI). Results: The results show that, with the protocol used, nitric acid 60% painlessly cured 40% (microbiologic cure) of the cases treated, and in all cases, clinical improvement was observed (p = 0.011). Conclusions: The treatment with nitric acid 60% is as efficient as conventional treatments, requires less patient compliance of the treatment and produces no pharmacological interactions, providing alternative treatment in the case of hepatotoxicity.<\/jats:p>","DOI":"10.3390\/ijerph182413371","type":"journal-article","created":{"date-parts":[[2021,12,19]],"date-time":"2021-12-19T20:37:27Z","timestamp":1639946247000},"page":"13371","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Preliminary Evidence of the Efficacy of Nitric Acid Treatment in Onychomycosis"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4696-4705","authenticated-orcid":false,"given":"F\u00e9lix","family":"Marcos-Tejedor","sequence":"first","affiliation":[{"name":"Department of Nursing, University Center of Plasencia, University of Extremadura, 10600 Plascencia, Spain"},{"name":"Department of Medical Sciences, Faculty of Health Sciences, University of Castilla-La Mancha, 45600 Talavera de la Reina, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natividad","family":"Santos-Carnicero","sequence":"additional","affiliation":[{"name":"Department of Anatomy and Human Embryology, University Center of Plasencia, University of Extremadura, 10600 Plasencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0798-7026","authenticated-orcid":false,"given":"Raquel","family":"Mayordomo","sequence":"additional","affiliation":[{"name":"Department of Anatomy and Human Embryology, University Center of Plasencia, University of Extremadura, 10600 Plasencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1177\/1203475417716362","article-title":"Onychomycosis in the 21st Century: An Update on Diagnosis, Epidemiology, and Treatment","volume":"21","author":"Gupta","year":"2017","journal-title":"J. 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