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
