Skin nontumor
Infectious disorders
Onychomycosis
Author: Nat Pernick, M.D.
Last author update: 1 July 2011
Last staff update: 7 March 2024
Copyright: 2002-2025, PathologyOutlines.com, Inc.
PubMed Search: Fungi - Onychomycosis [title]
Cite this page: Pernick N. Onychomycosis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/skinnontumorfungionychomycosis.html. Accessed January 12th, 2025.
Definition / general
- Spread of fungi to nail apparatus, caused by Trichophyton rubrum and Trichophyton mentagrophytes; also Candida albicans and Scopulariopis brevicaulis
- Often multiple fungal species
- Common in patients with diabetes; associated with NOT washing feet daily (Int J Nurs Stud 2011;48:1101)
- Proposed clinical classification: distal and lateral subungual (beneath the nail), superficial, endonyx (diffuse milky-white discolouration of affected nail but no nail bed hyperkeratosis and no onycholysis), proximal subungual, mixed, totally dystrophic and secondary onychomycosis (J Am Acad Dermatol 2011;65:1219)
Treatment
- Treatment recommended even with negative laboratory findings, because repeated testing is eventually positive in 94% (Clin Exp Dermatol 2011;36:724)
- Fungi are embedded in nail and are require months of treatment for success (Wikipedia)
- Systemic therapy includes terbinfine, itraconazole, griseofulvin and fluconazole or fluconazole 1% and urea 40% (J Dermatolog Treat 2012;23:453)
- Over the counter Vicks VapoRub may be effective (J Am Board Fam Med 2011;24:69)
- Initial trials suggest laser therapy may be useful (J Cosmet Laser Ther 2011;13:2)
Clinical images
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Toenail infections
