| SCIO
range |
Treatment
approach |
| 1-3 |
Topical treatment:
remove (cut or scrape off) affected marginal parts of
the nail; use topical antifungals until healthy nail regrowth |
| 3-6 |
Topical treatment with
lower success, which often depends on growth rate. Systemic
therapy recommended in slower-growing nails (Always systemic
therapy when this range of SCIO covers PSO). |
| 6-9 |
Systemic therapy. Use
scheme proposed for fingernails (E.g. terbinafine 6 wks
or 2 pulses of itraconazole). |
| 9-12 |
Systemic therapy. Use
scheme proposed for toenails (E.g. terbinafine 12 wks
or 3 pulses of itraconazole). |
| 12-16 |
Systemic therapy. Use
scheme of extended duration (E.g. terbinafine 16-18 wks
or 4-5 pulses of itraconazole). Success of systemic therapy
alone decreases with this SCIO range. |
| 16-20 |
Combination therapy (systemic+topical). Adequate
keratolytic treatment or nail avulsion recommended. Add
topical antifungals to cover all parts of the nail. |
| 20-30 |
Nail avulsion. Consider
removal of nail plate, e.g. with urea paste. Administer
systemic therapy then. |
