onychomycosis

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Etiology

Epidemiology

Pathology

Clinical manifestations

* images[12][13]

Laboratory

Complications

Differential diagnosis

* < 50% of nail dystrophies associated with fungal infection

Management

* drug of choice, 50% long-term success[2] not clear whether pulse dose as effective as continuous dose GRS10 suggests onychomycosis is not benign & needs to be treated[4] terbinafine is recommended treatment [4[

# 2nd best drug; pulse dose as effective as continuous dose

More general terms

References

  1. Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996. pg 983
  2. 2.0 2.1 2.2 2.3 2.4 2.5 2.6 Onychomycosis: Review of Treatment Options Prescriber's Letter 11(4):21 2004 Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=200405&pb=PRL (subscription needed) http://www.prescribersletter.com
  3. 3.00 3.01 3.02 3.03 3.04 3.05 3.06 3.07 3.08 3.09 3.10 Medical Knowledge Self Assessment Program (MKSAP) 15, 16, 18, 19. American College of Physicians, Philadelphia 2009, 2012, 2018, 2022.
    Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022
  4. 4.0 4.1 4.2 4.3 4.4 4.5 4.6 4.7 Geriatric Review Syllabus, 7th edition Parada JT et al (eds) American Geriatrics Society, 2010
    Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013
    Geriatric Review Syllabus, 10th edition (GRS10) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2019
  5. Prescriber's Letter 20(5): 2013 Comparison of Pharmacotherapy for Onychomycosis Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=290509&pb=PRL (subscription needed) http://www.prescribersletter.com
  6. 6.0 6.1 Elewski BE et al. Efinaconazole 10% solution in the treatment of toenail onychomycosis: Two phase III multicenter, randomized, double- blind studies. J Am Acad Dermatol 2013 Apr; 68:600 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23177180
  7. Welsh O, Vera-Cabrera L, Welsh E. Onychomycosis. Clin Dermatol. 2010 Mar 4;28(2):151-9 PMID: https://www.ncbi.nlm.nih.gov/pubmed/20347657
  8. de Berker D. Clinical practice. Fungal nail disease. N Engl J Med. 2009 May 14;360(20):2108-16 PMID: https://www.ncbi.nlm.nih.gov/pubmed/19439745
  9. 9.0 9.1 Derby R1, Rohal P, Jackson C, Beutler A, Olsen C. Novel treatment of onychomycosis using over-the-counter mentholated ointment: a clinical case series. J Am Board Fam Med. 2011 Jan-Feb;24(1):69-74 PMID: https://www.ncbi.nlm.nih.gov/pubmed/21209346
  10. Gupta AK, Uro M, Cooper EA. Onychomycosis therapy: past, present, future. J Drugs Dermatol. 2010 Sep;9(9):1109-13. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20865843
  11. 11.0 11.1 Alam M Does Laser Work for Treating Onychomycosis? Maybe, Sometimes. NEJM Journal Watch. Aug 28, 2014 Massachusetts Medical Society (subscription needed) http://www.jwatch.org
    Hollmig ST et al. Lack of efficacy with 1064-nm neodymium:yttrium-aluminum- garnet laser for the treatment of onychomycosis: A randomized, controlled trial. J Am Acad Dermatol 2014 May 15; 70:911. PMID: https://www.ncbi.nlm.nih.gov/pubmed/24641985
    Lim E-H et al. Toenail onychomycosis treated with a fractional carbon-dioxide laser and topical antifungal cream. J Am Acad Dermatol 2014 May 15; 70:918 PMID: https://www.ncbi.nlm.nih.gov/pubmed/24655819
  12. 12.0 12.1 Tosti A, MD; Elston RM (images) Medscape: Onychomycosis http://emedicine.medscape.com/article/1105828-overview
  13. 13.0 13.1 DermNet NZ. (images) Fungal nail infections (onychomycosis) http://www.dermnetnz.org/fungal/onychomycosis.html
  14. Lipner SR, Scher RK. Onychomycosis: Clinical overview and diagnosis. J Am Acad Dermatol. 2019 Apr;80(4):835-851. PMID: https://www.ncbi.nlm.nih.gov/pubmed/29959961 Review.
  15. 15.0 15.1 Leung AKC, Lam JM, Leong KF et al Onychomycosis: An Updated Review. Recent Pat Inflamm Allergy Drug Discov. 2020;14(1):32-45 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31738146 PMCID: PMC7509699 Free PMC article. Review.