Mom brings her 5 year old in with this.

ONYCHOMYCOSIS

Onychomycosis is infection of the nail by a fungus and is the most common nail disease.

• Some studies show a prevalence in the adult population of 5%.
• Onychomycosis is many times more common of the toenails than fingernails.
• When an older patient presents with several deformed or misshapen toenails, it may be impossible to distinguish by examination alone onychomycosis from old age.
  
• One study of patients over 60 found that 66% of patients had dystrophic nails suggestive of onychomycosis but culture showed that only 40% actually were infected.

How to Diagnose

The clinical appearance may be compelling. When less clear, KOH, culture or PAS staining of the nail plate may be necessary to diagnosis onychomycosis. Vikor Nail fungal ID is a process in which nail scrapings and/or clippings are analyzed by PCR and the presence of fungal element with predictive sensitivies are returned within 48 hours of reaching the lab.

Distal subungual onychomycosis (DSO) is the most common pattern of fungal infection of the nail.

Here, the clinician is using a currette to obtain subungual debris for culture.

Superficial white onychomycosis is a pattern of infection on the surface of the nail. The clinical appearance is that of a powdery, rough nail surface.

In endonyx onychomycosis, there is only color change of the nail plate (usually milky white) without onycholysis nor buildup of subungual debris.

The pattern of some nails dystrophic and other nails normal is a helpful clue to fungal infection.

Old age nails. NOT onychomycosis.

RegionalDerm

Who is Dr. White? | Privacy Policy | FAQs | Use of Images | Contact Dr. White