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Causes and symptoms
onychomycosis/on·y·cho·my·co·sis/ (-mi-ko´sis) tinea unguium.
onychomycosisAny infection of the nail caused by fungi, including nondermatophytes and yeast.
Onychomycosis, major types
• Candidal onychomycosis;
• Distal subungual onychomycosis;
• Proximal subungual onychomycosis;
• White superficial onychomycosis.
onychomycosisDermatophytic onychomycosis, fungal nail infection, mycotic toenail, ringworm of nail, tinea unguium Dermatology A fungal infection of nails, which makes them white, opaque, thicker, brittle High risk groups Older ♀–linked to estrogen deficiency which ↑ risk of infection, DM, small vessel vasculitis, artificial nails–acrylic or 'wraps'–the nail surface is usually abraded with an emery board, which itself may be a vector for fungi that really really like the moist, warm environment of the nails
onychomycosis(on?i-ko-mi-ko'sis) [ onycho- + mycosis]
Foot and nail care include keeping the feet and toes clean and dry, wearing fresh socks, changing shoes daily, and applying topical creams to the foot if the skin has cracked from athlete's foot. Paring away excessive nail growth (“debridement') reduces the thickness and length of affected nails and may enhance the effectiveness of medications. Some patients may have debridement performed professionally by a podiatrist.
Topical medications or oral (systemic) medications improve the appearance of fungal nail changes, but both are expensive and efficacy is only moderate. Oral antifungal drugs also carry the risk of liver damage and should be avoided by those with underlying liver compromise. Relapse rates after treatment are high.
onychomycosisFungus infection of the nails, usually by Candida or epidermophyton species.
onychomycosisfungal infection of the nail unit, due to Trichophyton rubrum or T. mentagrophytes infection; characterized by nail plate thickening and dystrophy, white/yellow/brown discoloration, chalkiness, friability and splitting, and a musty smell; treated by topical antifungal lacquers for 6 months or more, and/or systemic drugs such as terbinafine 250mg daily for 12-16 weeks (Table 1 and see Table 2)
|DLSO||Distal and lateral subungual onychomycosis: commonest presentation of onychomycosis; hyponychium is infected by the fungus leading to hyperkeratosis of the distal nail bed; spreads proximally to cause hyperkeratosis of the proximal nail bed and onycholysis|
|SWO||Superficial white onychomycosis: less common than DLSO; caused by infection with Trichophyton mentagrophytes ; affecting the dorsal nail plate; may respond to topical treatments|
|PSO||Proximal subungual onychomycosis: involvement of the proximal nail bed, spreading distally; due to infection with Candida sp. , T. rubrum and Scropulariopsis brevicaulis|
|TDO||Total dystrophic onychomycosis: the end result of untreated DLSO, SWO or PSO|
|CO||Candidal onychomycosis: nail involvement due to local spread from a chronic paronychia (typical of patients whose hands are habitually wet), distal nail plate infection (rare - mainly affecting patients with Raynaud's), chronic mucocutaneous candidiasis (due to an inborn defect of cell-mediated immunity) or due to opportunist yeast infection of psoriatic nails|
|EO||Endonyx onychomycosis: a rare form of onychomycosis caused by infection with T. soudanense|
|Interdigital skin infection (intertrigo)||Macerated tissue and webspace fissures Or dry, flaking tissue and webspace fissures ± pruritus|
|Moccasin skin infection||Dry, flaking skin affecting most of plantar surface, border skin and extending on to the dorsum from the interdigital spaces, ± pruritus|
|Hyperkeratotic skin infection||Increased formation of plantar keratin, with fissuring (especially around heels)|
|Vesicular skin infection||Intensely itchy, vesicular eruptions along plantar web line and medial longitudinal arch|
|Superficial nail infection||Formation of white, powdery patches or plaques on dorsal surface of one or many nails (also known as white superficial onychomycosis)|
|Tobacco nail||Formation of white/yellow/brown streak extending from distal to proximal area of intermediate nail plate, with local plate dystrophy|
|Total onychomycosis||Contamination of the entire nail plate by fungal infection, leading to plate hypertrophy, dystrophy, discoloration and onycholysis|