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Onychomycosis (cont.)

Fungal Nail Infection Prognosis

Several studies with the newer drugs (itraconazole or fluconazole) show significant cure rates, with fingernails having the most favorable prognosis. A cure may occur in some individuals with toenail infections after consistent lengthy treatments over many months. Unfortunately, most people will have some residual nail changes such as some discoloring, and about half will experience nail reinfection. Regrowth of toenails may take over a year to occur.

Summary of Common Types of Fungal Nail Infection

Characteristics of Common Types of Fungal Nail Infection

CharacteristicDLSOPSOWSO
FrequencyMost commonGenerally uncommon but frequent in AIDS patients10% of cases of OM
Progress of infectionInfection begins with invasion of the space under the nail edge where the nail separates from the nail bed (called the hyponychium)Infection begins at the nail fold (where the nail meets the finger or toe) and affects newly forming nailInfection begins at the surface of the nail (nail plate) and progresses to deeper layers
Clinical appearanceSeparation of the nail from the nail bed (onycholysis), thickening of the area under the nail (subungual hyperkeratosis)Subungual hyperkeratosis, white discoloration (leukonychia), separation of the nail from the nail bed (onycholysis), and destruction of the nail unitWhite areas on the nail surface, eventually involving the entire nail surface
Most common causative organismTrichophyton rubrumTrichophyton rubrumTrichophyton mentagrophytes, Aspergillus terreus, Acremonium roseogriseum, Fusarium oxysporum
Affected nailsToenails most commonly affected but may affect fingernails as wellMuch more common on the toenails, rarely affects fingernailsMainly affect toenails

The term total dystrophic onychomycosis is not a subtype, but is, instead, the final stage of any of the previously described forms of fungal nail infection, candidal fungal nail infection, or both

REFERENCES:

Onumah, Neh. "Nail Surgery." Medscape.com. Jan. 25, 2012. <http://emedicine.medscape.com/article/1126725-overview>.

Tosti, Antonella. "Onychomycosis." Medscape.com. Jan. 21, 2015. <http://emedicine.medscape.com/article/1105828-overview>.


Medically Reviewed by a Doctor on 3/17/2015

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Onychomycosis »

Onychomycosis (OM) refers to a fungal infection that affects the toenails or the fingernails.

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