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Onychomycosis
| Onychomycosis | |
|---|---|
| Other names | Dermatophytic onychomycosis[1] tinea unguium[1] |
 | |
| A toenail affected by onychomycosis | |
| Specialty | Infectious disease |
| Symptoms | White or yellow nail discoloration, thickening of the nail[2][3] |
| Complications | Lower leg cellulitis[3] |
| Usual onset | Older males[2][3] |
| Causes | Fungal infection[3] |
| Risk factors | Athlete's foot, other nail diseases, exposure to someone with the condition, peripheral vascular disease, poor immune function[3] |
| Diagnostic method | Based on appearance, confirmed by laboratory testing[2] |
| Differential diagnosis | Psoriasis, chronic dermatitis, chronic paronychia, nail trauma[2] |
| Treatment | None, anti-fungal medication, trimming the nails[2][3] |
| Medication | Terbinafine, ciclopirox[2] |
| Prognosis | Often recurs[2] |
| Frequency | ~10% of adults[2] |
Onychomycosis, also known as tinea unguium,[4] is a fungal infection of the nail.[2] Symptoms may include white or yellow nail discoloration, thickening of the nail, and separation of the nail from the nail bed.[2] Fingernails may be affected, but it is more common for toenails.[3] Complications may include cellulitis of the lower leg.[3] A number of different types of fungus can cause onychomycosis, including dermatophytes and Fusarium.[3] Risk factors include athlete's foot, other nail diseases, exposure to someone with the condition, peripheral vascular disease, and poor immune function.[3] The diagnosis is generally suspected based on the appearance and confirmed by laboratory testing.[2]
Onychomycosis does not necessarily require treatment.[3] The antifungal medication terbinafine taken by mouth appears to be the most effective but is associated with liver problems.[2][5] Trimming the affected nails when on treatment also appears useful.[2]
There is a ciclopirox-containing nail polish, but there is no evidence that it works.[2] The condition returns in up to half of cases following treatment.[2] Not using old shoes after treatment may decrease the risk of recurrence.[3]
Onychomycosis occurs in about 10 percent of the adult population,[2] with older people more frequently affected.[2] Males are affected more often than females.[3] Onychomycosis represents about half of nail disease.[2] It was first determined to be the result of a fungal infection in 1853 by Georg Meissner.[6]
- ^ a b Rapini 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 k l m n o p q r 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 "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. 2017 (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.
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