Onychomycosis: Current Trends In Diagnosis And Treatment ~ NewsWire

About Onychomycosis, Toenail Fungal infections of the toenails, causing thickening, roughness, and splitting, often caused by Trichophyton rubrum or T. mentagrophytes, Candida, and occasionally molds.Understanding Nail Mycosis- Nail Mycosis is also known as a fungal toenail infection. The causes vary from yeast, mold, athlete's foot, and dermatophytes. 80% of the population is affected by a nail fungus at some time in their life. The condition when addressed right away is easier to heal than if ignored.Treatonic Nail Fungus Treatment for toenail - Fungal Nail Treatment, Removes Yellow & Discoloration, Protect & Repair Brittle Cracked Nails. 4.4 out of 5 stars 22 $15.99 $ 15 . 99 ($15.99/Count)Superficial onychomycosis: Fungi invade the superficial layers of the nail plate and spread deeper into the nail plate as the infection progresses. Lesions are often white and are most often caused by T. mentagrophytes. Endonyx onychomycosis: Nail bed is not involved in the infection; only the interior of the nail plate is infected.What are fungal nail infections?. Fungal infection of the nails is also known as onychomycosis. It is increasingly common with increased age. It rarely affects children. Which organisms cause onychomycosis?. Onychomycosis can be due to: Dermatophytes such as Trichophyton rubrum (T. rubrum), T. interdigitale (tinea unguium); Yeasts such as Candida albicans and rarely, non-albicans Candida species

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Jump to navigation Jump to search OnychomycosisOther namesDermatophytic onychomycosis[1] tinea unguium[1]A toenail suffering from onychomycosisSpecialtyInfectious illnessSymptomsWhite or yellow nail discoloration, thickening of the nail[2][3]ComplicationsDecrease leg cellulitis[3]Usual onsetOlder men[2][3]CausesFungal an infection[3]Risk factorsAthlete's foot, other nail illnesses, publicity to any person with the situation, peripheral vascular disease, poor immune function[3]Diagnostic methodBased on appearance, showed by means of laboratory testing[2]Differential diagnosisPsoriasis, continual dermatitis, persistent paronychia, nail trauma[2]TreatmentNone, anti-fungal medication, trimming the nails[2][3]MedicationTerbinafine, ciclopirox[2]PrognosisSteadily recurs[2]Frequency~10% of adults[2]

Onychomycosis, sometimes called tinea unguium,[4] is a fungal infection of the nail.[2] Symptoms would possibly include white or yellow nail discoloration, thickening of the nail, and separation of the nail from the nail mattress.[2][3]Toenails or fingernails could also be affected, however it is more commonplace for toenails to be affected.[3] Complications would possibly come with cellulitis of the lower leg.[3] A variety of different types of fungus can cause onychomycosis, together with dermatophytes and Fusarium.[3] Risk factors come with athlete's foot, other nail sicknesses, exposure to any individual with the situation, peripheral vascular disease, and deficient immune function.[3] The analysis is typically suspected in response to the semblance and showed by way of laboratory testing.[2]

Onychomycosis does now not necessarily require treatment.[3] The antifungal medication terbinafine taken via mouth seems to be the most effective but is related to liver problems.[2][5] Trimming the affected nails when on remedy also appears helpful.[2]

There is a ciclopirox-containing nail polish, but there's no proof that it works.[2] The situation returns in up to half of cases following remedy.[2] Not the use of old sneakers after remedy may decrease the danger of recurrence.[3]

It happens in about 10 % of the adult inhabitants.[2] Older individuals are more incessantly affected.[2] Males are affected more continuously than ladies.[3] Onychomycosis represents about part of nail disease.[2] It was first made up our minds to be the result of a fungal an infection in 1853 via Georg Meissner.[6]

Etymology

The time period is from Greek ὄνυξ onyx 'nail', μύκης mykēs 'fungus',[7] and the suffix -ωσις -ōsis 'useful disease'.

Signs and symptoms

A case of fungal an infection of the massive toe Advanced fungal an infection of the massive toe

The most commonplace symptom of a fungal nail infection is the nail changing into thickened and discoloured: white, black, yellow or inexperienced. As the infection progresses the nail can change into brittle, with items breaking off or coming clear of the toe or finger completely. If left untreated, the surface underneath and around the nail can transform infected and painful. There can be white or yellow patches at the nailbed or scaly pores and skin subsequent to the nail,[8] and a foul smell.[9] There is in most cases no ache or different physically symptoms, until the illness is serious.[10] People with onychomycosis would possibly experience important psychosocial problems because of the semblance of the nail, in particular when arms – which might be always visible – rather than toenails are affected.[11]Dermatophytids are fungus-free pores and skin lesions that now and again form because of a fungus infection in another a part of the body. This may take the form of a rash or itch in an area of the body that's not inflamed with the fungus. Dermatophytids can be thought of as an allergic reaction to the fungus.

Causes

The causative pathogens of onychomycosis are all in the fungus kingdom and include dermatophytes, Candida (yeasts), and nondermatophytic molds.[2] Dermatophytes are the fungi most repeatedly answerable for onychomycosis within the temperate western nations; whilst Candida and nondermatophytic molds are more ceaselessly involved within the tropics and subtropics with a hot and humid climate.[12]

Dermatophytes

When onychomycosis is because of a dermatophyte an infection, it's termed tinea unguium. Trichophyton rubrum is the most common dermatophyte considering onychomycosis. Other dermatophytes that may be involved are T. interdigitale, Epidermophyton floccosum, T. violaceum, Microsporum gypseum, T. tonsurans, and T. soudanense. A common out of date name that may nonetheless be reported by means of scientific laboratories is Trichophyton mentagrophytes for T. interdigitale. The title T. mentagrophytes is now restricted to the agent of favus skin infection of the mouse; though this fungus could also be transmitted from mice and their danders to humans, it generally infects skin and no longer nails.

Other

Other causative pathogens include Candida and nondermatophytic molds, in particular contributors of the mold genus Scytalidium (title recently modified to Neoscytalidium), Scopulariopsis, and Aspergillus. Candida species principally motive fingernail onychomycosis in other folks whose arms are regularly submerged in water. Scytalidium basically impacts other people within the tropics, though it persists in the event that they later transfer to spaces of temperate local weather.

Other molds more recurrently affect other folks older than 60 years, and their presence within the nail reflects a slight weakening in the nail's ability to defend itself in opposition to fungal invasion.

Risk elements

Aging is the most typical chance issue for onychomycosis due to lowered blood circulate, longer exposure to fungi, and nails which grow extra slowly and thicken, expanding susceptibility to infection. Nail fungus has a tendency to impact men extra frequently than ladies and is associated with a circle of relatives historical past of this infection.

Other possibility elements include perspiring heavily, being in a damp or moist atmosphere, psoriasis, wearing socks and sneakers that hinder air flow and do not take in perspiration, going barefoot in damp public places similar to swimming swimming pools, gyms and shower rooms, having athlete's foot (tinea pedis), minor pores and skin or nail harm, damaged nail, or different infection, and having diabetes, movement issues, which might also result in lower peripheral temperatures on hands and ft, or a weakened immune machine.[13]

Diagnosis

The prognosis is in most cases suspected in keeping with the appearance and showed by laboratory trying out.[2] The four main tests are a potassium hydroxide smear, tradition, histology examination, and polymerase chain response.[2][3] The sample tested is generally nail scrapings or clippings.[2] These being from as some distance up the nail as conceivable.[3]

Nail plate biopsy with periodic acid-Schiff stain appear more helpful than tradition or direct KOH examination.[14] To reliably identify nondermatophyte molds, a number of samples is also important.[15]

Classification

There are 5 vintage sorts of onychomycosis:[16][17]

Distal subungual onychomycosis is the most common type of tinea unguium[2] and is usually caused by means of Trichophyton rubrum, which invades the nail bed and the underside of the nail plate. White superficial onychomycosis (WSO) is brought about by means of fungal invasion of the superficial layers of the nail plate to shape "white islands" at the plate. It accounts for around 10 p.c of onychomycosis circumstances. In some instances, WSO is a misdiagnosis of "keratins granulations" which don't seem to be a fungus, however a response to nail polish that can cause the nails to have a chalky white look. A laboratory test should be carried out to verify.[18] Proximal subungual onychomycosis is fungal penetration of the newly formed nail plate in the course of the proximal nail fold. It is the least not unusual form of tinea unguium in healthy other people, however is found extra often when the patient is immunocompromised.[2] Endonyx onychomycosis is characterised through leukonychia at the side of a loss of onycholysis or subungual hyperkeratosis.[17] Candidal onychomycosis is Candida species invasion of the fingernails, in most cases occurring in individuals who incessantly immerse their palms in water. This most often calls for the prior harm of the nail by an infection or trauma.Differential diagnosis

In many instances of suspected nail fungus there may be in truth no fungal infection, but most effective nail deformity.[19][20]

To steer clear of misdiagnosis as nail psoriasis, lichen planus, contact dermatitis, nail bed tumors reminiscent of melanoma, trauma, or yellow nail syndrome, laboratory confirmation is also essential.[2]

Other stipulations that may seem similar to onychomycosis come with: psoriasis, commonplace getting older, yellow nail syndrome, and protracted paronychia.[21]

Treatment

A person's foot with a fungal nail infection ten weeks right into a process terbinafine oral medication. Note the band of wholesome (purple) nail enlargement behind the remainder infected nails. Medications

Most remedies are with antifungal medicines both topically or via mouth.[2] Avoiding use of antifungal treatment by way of mouth (e.g. terbinafine) in persons without a confirmed infection is beneficial because of the conceivable uncomfortable side effects of that remedy.[19]

Topical brokers include ciclopirox nail paint, amorolfine, and efinaconazole.[22][23][24] Some topical treatments need to be carried out day-to-day for extended classes (a minimum of 1 year).[23] Topical amorolfine is implemented weekly.[25] Topical ciclopirox results in a cure in 6% to 9% of instances; amorolfine may well be simpler.[2][23] Ciclopirox when used with terbinafine appears to be better than both agent by myself.[2] In trials, about 17% of folks were cured using efinaconazole versus 4% of other people the use of placebo.[26] Although eficonazole, P-3051 (ciclopirox 8% hydrolacquer), and tavaborole are efficient at treating fungal an infection of toenails, whole remedy charges are low.[27]

Medications that can be taken by way of mouth come with terbinafine (76% effective), itraconazole (60% efficient) and fluconazole (48% efficient).[2] They proportion characteristics that improve their effectiveness: recommended penetration of the nail and nail bed,[28] and endurance within the nail for months after discontinuation of treatment.[29]Ketoconazole by way of mouth isn't beneficial due to side effects.[30] Oral terbinafine is healthier tolerated than itraconazole.[31] For superficial white onychomycosis, systemic fairly than topical antifungal remedy is suggested.[32]

Other

Chemical (keratolytic) or surgical debridement of the affected nail appears to toughen results.[2]

As of 2014 proof for laser remedy is unclear as the evidence is of low high quality[33] and varies by way of form of laser.[34]

Tea tree oil is not beneficial as a treatment, since it isn't effective and will irritate the encompassing pores and skin.[35]

Cost United States

According to a 2015 find out about, the price within the United States of testing with the periodic acid–Schiff stain (PAS) was about 8. Even if the cheaper KOH check is used first and the PAS check is used only if the KOH check is detrimental, there is a good chance that the PAS shall be done (as a result of either a true or a false unfavourable with the KOH take a look at). But the terbinafine remedy prices most effective (plus an extra for liver serve as exams). In conclusion the authors say that terbinafine has a slightly benign opposed impact profile, with liver harm very uncommon, so it makes more sense cost-wise for the dermatologist to prescribe the treatment with out doing the PAS check. (Another choice can be to prescribe the treatment provided that the potassium hydroxide take a look at is positive, nevertheless it gives a false negative in about 20% of instances of fungal an infection.) On the opposite hand, as of 2015 the cost of topical (non-oral) treatment with efinaconazole was once 07 according to nail, so testing is really helpful prior to prescribing it.[20]

Prognosis

Following effective treatment, recurrence is commonplace (10–50%).[2] Nail fungus may also be painful and motive everlasting injury to nails. It might lead to different severe infections if the immune machine is suppressed due to medicine, diabetes or different prerequisites. The chance is maximum severe for other people with diabetes and with immune systems weakened by means of leukemia or AIDS, or medicine after organ transplant. Diabetics have vascular and nerve impairment, and are vulnerable to cellulitis, a potentially serious bacterial an infection; any fairly minor damage to toes, including a nail fungal an infection, can lead to more serious complications.[36]Infection of the bone is another uncommon complication.[8]

Epidemiology

A 2003 survey of sicknesses of the foot in 16 European nations found onychomycosis to be essentially the most common fungal foot infection and estimates its prevalence at 27%.[37][38] Prevalence was seen to extend with age. In Canada, the superiority was once estimated to be 6.48%.[39] Onychomycosis affects roughly one-third of diabetics[40] and is 56% more common in other people suffering from psoriasis.[41]

Research

Research suggests that fungi are delicate to warmth, in most cases 40–60 °C (104–140 °F). The basis of laser remedy is to check out to heat the nail mattress to these temperatures so as to disrupt fungal enlargement.[42] As of 2013 research into laser remedy seems promising.[2] There is also ongoing development in photodynamic remedy, which uses laser or LED mild to turn on photosensitisers that eradicate fungi.[43]

References

^ a b .mw-parser-output cite.citationfont-style:inherit.mw-parser-output .quotation qquotes:"\"""\"""'""'".mw-parser-output .id-lock-free a,.mw-parser-output .citation .cs1-lock-free abackground:linear-gradient(transparent,transparent),url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")correct 0.1em middle/9px no-repeat.mw-parser-output .id-lock-limited a,.mw-parser-output .id-lock-registration a,.mw-parser-output .citation .cs1-lock-limited a,.mw-parser-output .citation .cs1-lock-registration abackground:linear-gradient(clear,transparent),url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")appropriate 0.1em center/9px no-repeat.mw-parser-output .id-lock-subscription a,.mw-parser-output .citation .cs1-lock-subscription abackground:linear-gradient(transparent,transparent),url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat.mw-parser-output .cs1-subscription,.mw-parser-output .cs1-registrationcolour:#555.mw-parser-output .cs1-subscription span,.mw-parser-output .cs1-registration spanborder-bottom:1px dotted;cursor:assist.mw-parser-output .cs1-ws-icon abackground:linear-gradient(transparent,clear),url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")correct 0.1em center/12px no-repeat.mw-parser-output code.cs1-codecolour:inherit;background:inherit;border:none;padding:inherit.mw-parser-output .cs1-hidden-errorshow:none;font-size:100%.mw-parser-output .cs1-visible-errorfont-size:100%.mw-parser-output .cs1-maintshow:none;color:#33aa33;margin-left:0.3em.mw-parser-output .cs1-formatfont-size:95%.mw-parser-output .cs1-kern-left,.mw-parser-output .cs1-kern-wl-leftpadding-left:0.2em.mw-parser-output .cs1-kern-right,.mw-parser-output .cs1-kern-wl-rightpadding-right:0.2em.mw-parser-output .citation .mw-selflinkfont-weight:inheritRapini RP, Bolognia JL, Jorizzo JL (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. p. 1135. ISBN 978-1-4160-2999-1. ^ a b c d e f g h i j ok l m n o p q r s t u v w x y z aa ab ac advert ae af Westerberg DP, Voyack MJ (December 2013). "Onychomycosis: Current trends in diagnosis and treatment". American Family Physician. 88 (11): 762–70. PMID 24364524. ^ a b c d e f g h i j k l m n o p "Onychomycosis – Dermatologic Disorders". Merck Manuals Professional Edition. February 2017. Retrieved 2 June 2018. ^ Rodgers P, Bassler M (February 2001). "Treating onychomycosis". American Family Physician. 63 (4): 663–72, 677–8. PMID 11237081. ^ Kreijkamp-Kaspers S, Hawke K, Guo L, Kerin G, Bell-Syer SE, Magin P, et al. (July 2017). "Oral antifungal medication for toenail onychomycosis". The Cochrane Database of Systematic Reviews. 7: CD010031. doi:10.1002/14651858.CD010031.pub2. PMC 6483327. PMID 28707751. ^ Rigopoulos D, Elewski B, Richert B (2018). Onychomycosis: Diagnosis and Effective Management. John Wiley & Sons. ISBN 9781119226505. ^ ὄνυξ, μύκης. Liddell, Henry George; Scott, Robert; A Greek–English Lexicon at the Perseus Project. ^ a b NHS Choices: Symptoms of fungal nail an infection ^ Mayo clinic: Nail fungus ^ Onychomycosis at eMedicine ^ Szepietowski JC, Reich A (July 2009). "Stigmatisation in onychomycosis patients: a population-based study". Mycoses. 52 (4): 343–9. doi:10.1111/j.1439-0507.2008.01618.x. PMID 18793262. ^ Chi CC, Wang SH, Chou MC (November 2005). "The causative pathogens of onychomycosis in southern Taiwan". Mycoses. 48 (6): 413–20. doi:10.1111/j.1439-0507.2005.01152.x. PMID 16262878. ^ Mayo Clinic – Nail fungus – possibility factors ^ Velasquez-Agudelo V, Cardona-Arias JA (February 2017). "Meta-analysis of the utility of culture, biopsy, and direct KOH examination for the diagnosis of onychomycosis". BMC Infectious Diseases. 17 (1): 166. doi:10.1186/s12879-017-2258-3. PMC 5320683. PMID 28222676. ^ Shemer A, Davidovici B, Grunwald MH, Trau H, Amichai B (January 2009). "New criteria for the laboratory diagnosis of nondermatophyte moulds in onychomycosis". The British Journal of Dermatology. 160 (1): 37–9. doi:10.1111/j.1365-2133.2008.08805.x. PMID 18764841. S2CID 42320540. ^ James WD, Berger TG (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0. ^ a b Tosti, Antonella (31 Jul 2018). Elston, Dirk M; Vinson, Richard P (eds.). "Onychomycosis". Medscape. Retrieved 18 Jun 2020. ^ "AAPA". Cmecorner.com. Retrieved 2010-08-05. ^ a b American Academy of Dermatology (February 2013), "Five Things Physicians and Patients Should Question", Choosing Wisely: an initiative of the ABIM Foundation, American Academy of Dermatology, retrieved 5 December 2013. Which cites:* Roberts DT, Taylor WD, Boyle J (March 2003). "Guidelines for treatment of onychomycosis" (PDF). The British Journal of Dermatology. 148 (3): 402–10. doi:10.1046/j.1365-2133.2003.05242.x. PMID 12653730. S2CID 33750748. ^ a b Mikailov A, Cohen J, Joyce C, Mostaghimi A (March 2016). "Cost-effectiveness of Confirmatory Testing Before Treatment of Onychomycosis". JAMA Dermatology. 152 (3): 276–81. doi:10.1001/jamadermatol.2015.4190. PMID 26716567. ^ Hall B (2012). Sauer's Manual of Skin Diseases (10 ed.). Lippincott Williams & Wilkins. p. Chapter 33. ISBN 9781451148688. ^ Rodgers P, Bassler M (February 2001). "Treating onychomycosis". American Family Physician. 63 (4): 663–72, 677–8. PMID 11237081. ^ a b c Crawford F, Hollis S (July 2007). Crawford F (ed.). "Topical treatments for fungal infections of the skin and nails of the foot". The Cochrane Database of Systematic Reviews (3): CD001434. doi:10.1002/14651858.CD001434.pub2. PMC 7073424. PMID 17636672. ^ Gupta AK, Paquet M (2014). "Efinaconazole 10% nail solution: a new topical treatment with broad antifungal activity for onychomycosis monotherapy". Journal of Cutaneous Medicine and Surgery. 18 (3): 151–5. doi:10.2310/7750.2013.13095. PMID 24800702. S2CID 10079807. ^ Loceryl (5% amorolfine) package labelling ^ "Drugs at FDA: JUBLIA" (PDF). Retrieved 26 June 2014. ^ Foley K, Gupta AK, Versteeg S, Mays R, Villanueva E, John D, et al. (Cochrane Skin Group) (January 2020). "Topical and device-based treatments for fungal infections of the toenails". The Cochrane Database of Systematic Reviews. 1: CD012093. doi:10.1002/14651858.CD012093.pub2. PMC 6984586. PMID 31978269. ^ Elewski BE (July 1998). "Onychomycosis: pathogenesis, diagnosis, and management". Clinical Microbiology Reviews. 11 (3): 415–29. doi:10.1128/CMR.11.3.415. PMC 88888. PMID 9665975. ^ Elewski BE, Hay RJ (August 1996). "Update on the management of onychomycosis: highlights of the Third Annual International Summit on Cutaneous Antifungal Therapy". Clinical Infectious Diseases. 23 (2): 305–13. doi:10.1093/clinids/23.2.305. PMID 8842269. ^ "Nizoral (ketoconazole) Oral Tablets: Drug Safety Communication - Prescribing for Unapproved Uses including Skin and Nail Infections Continues; Linked to Patient Death". FDA. 19 May 2016. Retrieved 20 May 2016. ^ Haugh M, Helou S, Boissel JP, Cribier BJ (July 2002). "Terbinafine in fungal infections of the nails: a meta-analysis of randomized clinical trials". The British Journal of Dermatology. 147 (1): 118–21. doi:10.1046/j.1365-2133.2002.04825.x. PMID 12100193. S2CID 19682557. ^ Baran R, Faergemann J, Hay RJ (November 2007). "Superficial white onychomycosis--a syndrome with different fungal causes and paths of infection". Journal of the American Academy of Dermatology. 57 (5): 879–82. doi:10.1016/j.jaad.2007.05.026. PMID 17610995. ^ Bristow IR (2014). "The effectiveness of lasers in the treatment of onychomycosis: a systematic review". Journal of Foot and Ankle Research. 7: 34. doi:10.1186/1757-1146-7-34. PMC 4124774. PMID 25104974. ^ Liddell LT, Rosen T (April 2015). "Laser Therapy for Onychomycosis: Fact or Fiction?". Journal of Fungi. 1 (1): 44–54. doi:10.3390/jof1010044. PMC 5770012. PMID 29376898. ^ Halteh P, Scher RK, Lipner SR (November 2016). "Over-the-counter and natural remedies for onychomycosis: do they really work?". Cutis. 98 (5): E16–E25. PMID 28040821. ^ Mayo sanatorium – Nail fungus: headaches ^ Burzykowski T, Molenberghs G, Abeck D, Haneke E, Hay R, Katsambas A, et al. (December 2003). "High prevalence of foot diseases in Europe: results of the Achilles Project". Mycoses. 46 (11–12): 496–505. doi:10.1046/j.0933-7407.2003.00933.x. hdl:1942/429. PMID 14641624. ^ Verma S, Heffernan MP (2008). Superficial fungal an infection: Dermatophytosis, onychomycosis, tinea nigra, piedra. In Ok Wolff et al., eds., Fitzpatrick's Dermatology in General Medicine, 7th ed., vol 2, pp. 1807–1821. New York: McGraw Hill. ^ Vender, Ronald B.; Lynde, Charles W.; Poulin, Yves (2006). "Prevalence and epidemiology of onychomycosis". Journal of Cutaneous Medicine and Surgery. 10 Suppl 2 (6_suppl): S28–S33. doi:10.2310/7750.2006.00056. PMID 17204229. S2CID 74819774. ^ Gupta AK, Konnikov N, MacDonald P, Rich P, Rodger NW, Edmonds MW, et al. (October 1998). "Prevalence and epidemiology of toenail onychomycosis in diabetic subjects: a multicentre survey". The British Journal of Dermatology. 139 (4): 665–71. doi:10.1046/j.1365-2133.1998.02464.x. PMID 9892911. S2CID 22038748. ^ Gupta AK, Lynde CW, Jain HC, Sibbald RG, Elewski BE, Daniel CR, et al. (May 1997). "A higher prevalence of onychomycosis in psoriatics compared with non-psoriatics: a multicentre study". The British Journal of Dermatology. 136 (5): 786–9. doi:10.1046/j.1365-2133.1997.6771624.x. PMID 9205520. S2CID 5969796. ^ "Device-based Therapies for Onychomycosis Treatment". Retrieved 23 December 2012. ^ Piraccini BM, Alessandrini A (March 2015). "Onychomycosis: A Review". Journal of Fungi. 1 (1): 30–43. doi:10.3390/jof1010030. PMC 5770011. PMID 29376897.

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ClassificationDICD-10: B35.1ICD-9-CM: 110.1MeSH: D014009DiseasesDB: 13125External resourcesMedlinePlus: 001330eMedicine: derm/300Patient UK: OnychomycosisvteDiseases of the skin and appendages by morphologyGrowthsEpidermal Wart Callus Seborrheic keratosis Acrochordon Molluscum contagiosum Actinic keratosis Squamous-cell carcinoma Basal-cell carcinoma Merkel-cell carcinoma Nevus sebaceous TrichoepitheliomaPigmented Freckles Lentigo Melasma Nevus MelanomaDermal andsubcutaneous Epidermal inclusion cyst Hemangioma Dermatofibroma (benign fibrous histiocytoma) Keloid Lipoma Neurofibroma Xanthoma Kaposi's sarcoma Infantile virtual fibromatosis Granular mobile tumor Leiomyoma Lymphangioma circumscriptum Myxoid cystRashesWith epidermal involvementEczematous Contact dermatitis Atopic dermatitis Seborrheic dermatitis Stasis dermatitis Lichen simplex chronicus Darier's disease Glucagonoma syndrome Langerhans cell histiocytosis Lichen sclerosus Pemphigus foliaceus Wiskott–Aldrich syndrome Zinc deficiencyScaling Psoriasis Tinea (Corporis Cruris Pedis Manuum Faciei) Pityriasis rosea Secondary syphilis Mycosis fungoides Systemic lupus erythematosus Pityriasis rubra pilaris Parapsoriasis IchthyosisBlistering Herpes simplex Herpes zoster Varicella Bullous impetigo Acute touch dermatitis Pemphigus vulgaris Bullous pemphigoid Dermatitis herpetiformis Porphyria cutanea tarda Epidermolysis bullosa simplexPapular Scabies Insect chew reactions Lichen planus Miliaria Keratosis pilaris Lichen spinulosus Transient acantholytic dermatosis Lichen nitidus Pityriasis lichenoides et varioliformis acutaPustular Acne vulgaris Acne rosacea Folliculitis Impetigo Candidiasis Gonococcemia Dermatophyte Coccidioidomycosis Subcorneal pustular dermatosisHypopigmented Tinea versicolor Vitiligo Pityriasis alba Postinflammatory hyperpigmentation Tuberous sclerosis Idiopathic guttate hypomelanosis Leprosy Hypopigmented mycosis fungoidesWithout epidermal involvementRedBlanchableErythemaGeneralized Drug eruptions Viral exanthems Toxic erythema Systemic lupus erythematosusLocalized Cellulitis Abscess Boil Erythema nodosum Carcinoid syndrome Fixed drug eruptionSpecialized Urticaria Erythema (Multiforme Migrans Gyratum repens Annulare centrifugum Ab igne)Nonblanchable PurpuraMacular Thrombocytopenic purpura Actinic/sun purpuraPapular Disseminated intravascular coagulation VasculitisIndurated Scleroderma/morphea Granuloma annulare Lichen sclerosis et atrophicus Necrobiosis lipoidicaMiscellaneous disordersUlcers Hair Telogen effluvium Androgenic alopecia Alopecia areata Systemic lupus erythematosus Tinea capitis Loose anagen syndrome Lichen planopilaris Folliculitis decalvans Acne keloidalis nuchaeNail Onychomycosis Psoriasis Paronychia Ingrown nailMucous membrane Aphthous stomatitis Oral candidiasis Lichen planus Leukoplakia Pemphigus vulgaris Mucous membrane pemphigoid Cicatricial pemphigoid Herpesvirus Coxsackievirus Syphilis Systemic histoplasmosis Squamous-cell carcinoma vteFungal an infection and mesomycetozoeaSuperficial andcutaneous(dermatomycosis):Tinea = pores and skin;Piedra (exothrix/endothrix) = hairAscomycotaDermatophyte(Dermatophytosis)By location Tinea barbae/tinea capitis Kerion Tinea corporis Ringworm Dermatophytids Tinea cruris Tinea manuum Tinea pedis (athlete's foot) Tinea unguium/onychomycosis White superficial onychomycosis Distal subungual onychomycosis Proximal subungual onychomycosis Tinea corporis gladiatorum Tinea faciei Tinea imbricata Tinea incognito FavusBy organism Epidermophyton floccosum Microsporum canis Microsporum audouinii Trichophyton interdigitale/mentagrophytes Trichophyton tonsurans Trichophyton schoenleini Trichophyton rubrum Trichophyton verrucosumOther Hortaea werneckii Tinea nigra Piedraia hortae Black piedraBasidiomycota Malassezia furfur Tinea versicolor Pityrosporum folliculitis Trichosporon White piedraSubcutaneous,systemic,and opportunisticAscomycotaDimorphic(yeast+mold)Onygenales Coccidioides immitis/Coccidioides posadasii Coccidioidomycosis Disseminated coccidioidomycosis Primary cutaneous coccidioidomycosis. Primary pulmonary coccidioidomycosis Histoplasma capsulatum Histoplasmosis Primary cutaneous histoplasmosis Primary pulmonary histoplasmosis Progressive disseminated histoplasmosis Histoplasma duboisii African histoplasmosis Lacazia loboi Lobomycosis Paracoccidioides brasiliensis ParacoccidioidomycosisOther Blastomyces dermatitidis Blastomycosis North American blastomycosis South American blastomycosis Sporothrix schenckii Sporotrichosis Talaromyces marneffei TalaromycosisYeast-like Candida albicans Candidiasis Oral Esophageal Vulvovaginal Chronic mucocutaneous Antibiotic candidiasis Candidal intertrigo Candidal onychomycosis Candidal paronychia Candidid Diaper candidiasis Congenital cutaneous candidiasis Perianal candidiasis Systemic candidiasis Erosio interdigitalis blastomycetica C. auris C. glabrata C. lusitaniae C. tropicalis Pneumocystis jirovecii Pneumocystosis Pneumocystis pneumoniaMold-like Aspergillus Aspergillosis Aspergilloma Allergic bronchopulmonary aspergillosis Primary cutaneous aspergillosis Exophiala jeanselmei Eumycetoma Fonsecaea pedrosoi/Fonsecaea compacta/Phialophora verrucosa Chromoblastomycosis Geotrichum candidum Geotrichosis Pseudallescheria boydii AllescheriasisBasidiomycota Cryptococcus neoformans Cryptococcosis Trichosporon spp TrichosporonosisZygomycota (Zygomycosis)Mucorales (Mucormycosis) Rhizopus oryzae Mucor indicus Lichtheimia corymbifera Syncephalastrum racemosum Apophysomyces variabilisEntomophthorales (Entomophthoramycosis) Basidiobolus ranarum Basidiobolomycosis Conidiobolus coronatus/Conidiobolus incongruus ConidiobolomycosisMicrosporidia (Microsporidiosis) Enterocytozoon bieneusi/Encephalitozoon intestinalisMesomycetozoea Rhinosporidium seeberi RhinosporidiosisUngrouped Alternariosis Fungal folliculitis Fusarium Fusariosis Granuloma gluteale infantum Hyalohyphomycosis Otomycosis Phaeohyphomycosis vteDisorders of skin appendagesNail thickness: Onychogryphosis Onychauxiscolor: Beau's strains Yellow nail syndrome Leukonychia Azure lunulashape: Koilonychia Nail clubbingbehavior: Onychotillomania Onychophagiaother: Ingrown nail Anonychiaungrouped: Paronychia Acute Chronic Chevron nail Congenital onychodysplasia of the index palms Green nails Half and half nails Hangnail Hapalonychia Hook nail Ingrown nail Lichen planus of the nails Longitudinal erythronychia Malalignment of the nail plate Median nail dystrophy Mees' lines Melanonychia Muehrcke's lines Nail–patella syndrome Onychoatrophy Onycholysis Onychomadesis Onychomatricoma Onychomycosis Onychophosis Onychoptosis defluvium Onychorrhexis Onychoschizia Platonychia Pincer nails Plummer's nail Psoriatic nails Pterygium inversum unguis Pterygium unguis Purpura of the nail mattress Racquet nail Red lunulae Shell nail syndrome Splinter hemorrhage Spotted lunulae Staining of the nail plate Stippled nails Subungual hematoma Terry's nails Twenty-nail dystrophyHairHair loss/Baldness noncicatricial alopecia: Alopecia areata totalis universalis OphiasisAndrogenic alopecia (male-pattern baldness) Hypotrichosis Telogen effluvium Traction alopecia Lichen planopilaris Trichorrhexis nodosa Alopecia neoplastica Anagen effluvium Alopecia mucinosacicatricial alopecia: Pseudopelade of Brocq Central centrifugal cicatricial alopecia Pressure alopecia Traumatic alopecia Tumor alopecia Hot comb alopecia Perifolliculitis capitis abscedens et suffodiens Graham-Little syndrome Folliculitis decalvansungrouped: Triangular alopecia Frontal fibrosing alopecia Marie Unna hereditary hypotrichosisHypertrichosis Hirsutism Acquired localised generalised patterned Congenital generalised localised X-linked PrepubertalAcneiformeruptionAcne Acne vulgaris Acne conglobata Acne miliaris necrotica Tropical pimples Infantile acne/Neonatal zits Excoriated zits Acne fulminans Acne medicamentosa (e.g., steroid acne) Halogen pimples Iododerma Bromoderma Chloracne Oil zits Tar zits Acne cosmetica Occupational zits Acne aestivalis Acne keloidalis nuchae Acne mechanica Acne with facial edema Pomade zits Acne necrotica Blackhead Lupus miliaris disseminatus facieiRosacea Perioral dermatitis Granulomatous perioral dermatitis Phymatous rosacea Rhinophyma Blepharophyma Gnathophyma Metophyma Otophyma Papulopustular rosacea Lupoid rosacea Erythrotelangiectatic rosacea Glandular rosacea Gram-negative rosacea Steroid rosacea Ocular rosacea Persistent edema of rosacea Rosacea conglobata variants Periorificial dermatitis Pyoderma facialeUngrouped Granulomatous facial dermatitis Idiopathic facial aseptic granuloma Periorbital dermatitis SAPHO syndromeFollicular cysts "Sebaceous cyst" Epidermoid cyst Trichilemmal cyst Steatocystoma simplex multiplex MiliaInflammation Folliculitis Folliculitis nares perforans Tufted folliculitis Pseudofolliculitis barbaeHidradenitis Hidradenitis suppurativa Recurrent palmoplantar hidradenitis Neutrophilic eccrine hidradenitisUngrouped Acrokeratosis paraneoplastica of Bazex Acroosteolysis Bubble hair deformity Disseminate and recurrent infundibulofolliculitis Erosive pustular dermatitis of the scalp Erythromelanosis follicularis faciei et colli Hair casts Hair follicle nevus Intermittent hair–follicle dystrophy Keratosis pilaris atropicans Kinking hair Koenen's tumor Lichen planopilaris Lichen spinulosus Loose anagen syndrome Menkes kinky hair syndrome Monilethrix Parakeratosis pustulosa Pili (Pili annulati Pili bifurcati Pili multigemini Pili pseudoannulati Pili torti) Pityriasis amiantacea Plica neuropathica Poliosis Rubinstein–Taybi syndrome Setleis syndrome Traumatic anserine folliculosis Trichomegaly Trichomycosis axillaris Trichorrhexis (Trichorrhexis invaginata Trichorrhexis nodosa) Trichostasis spinulosa Uncombable hair syndrome Wooly hair nevusSweatglandsEccrine Miliaria Colloid milium Miliaria crystalline Miliaria profunda Miliaria pustulosa Miliaria rubra Occlusion miliaria Postmiliarial hypohidrosis Granulosis rubra nasi Ross' syndrome Anhidrosis Hyperhidrosis Generalized Gustatory PalmoplantarApocrine Body scent Chromhidrosis Fox–Fordyce diseaseSebaceous Sebaceous hyperplasia Retrieved from "https://en.wikipedia.org/w/index.php?title=Onychomycosis&oldid=1021305915"

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