Onychomycosis

Summary

  • Dermatophyte infection of the nail plate
  • Commonly Trichophyton rubrum (70%) or Trichophyton mentagrophytes (20%)
  • Non-dermatophyte moulds are rare (10%)

 

Diagnostic tips

  • White or yellow/brown discoloration of the nail plate
  • Classified as
    • Distal Subungual Onychomycosis
    • Proximal Subungual Onychomycosis
    • White Superficial Onychomycosis
    • Total Dystrophic Onychomycosis
  • Onychomycosis accounts for only about half of all nail dystrophies
  • Onychomycosis may be secondary to other nail dystrophies.

 

Tests and Imaging

  • Microscopy and culture of samples from both the nail plate and the affected nail bed.
  • Adequate sample size is essential for accurate analysis.

 

Immediate Treatment

  • Debridement of the affected nail tissue and application of topical agents
  • Oral terbinafine, itraconazole, or fluconazole may be indicated for severe cases
  • Tea Tree Oil and Eucalyptus Oil have both shown to be effective when applied daily, however the data is inconclusive

 

 

Possible Referral

  • Podiatry for expert debridement and advice on disinfection of footwear and hosiery
  • Podiatry for treatment which may include Photodynamic Therapy or Laser

 

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