Which medications in the drug class Antifungals are used in the treatment of Paronychia?

Updated: Oct 09, 2020
  • Author: Elizabeth M Billingsley, MD; Chief Editor: William D James, MD  more...
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The mechanism of action of antifungal agents usually involves the alteration of the permeability of the cell membrane (polyenes) of the fungal cell or the inhibition of pathways (enzymes, substrates, transport) necessary for sterol/cell membrane synthesis.

Miconazole topical (Desenex Spray, Lotrimin AF, Baza Antifungal, Carrington Antifungal, Micaderm, Micatin)

This agent damages the fungal cell wall membrane by inhibiting the biosynthesis of ergosterol. By increasing membrane permeability, it causes nutrients to leak out of the cell, resulting in fungal cell death. Lotion is preferred in intertriginous areas. If cream is used, it should be applied sparingly to avoid maceration effects.

Ketoconazole (Nizoral, Extina, Xologel)

Ketoconazole has fungistatic activity. An imidazole with broad-spectrum antifungal action, it inhibits the synthesis of ergosterol, causing cellular components to leak and resulting in fungal cell death.

Itraconazole (Sporanox, Onmel)

This is a synthetic fungistatic triazole that inhibits cytochrome P-450–dependent synthesis of ergosterol, a vital component of fungal cell membranes.

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