By Gary M. White, MD

Proximal subungual onychomycosis

Proximal subungual onychomycosis is a rare type of fungal infection in which the fungus invades the area under the nail via the proximal nail fold. This type of infection is most common in the HIV-positive population.


A proximal whitish discoloration occurs under the nail.


One may need to use a punch or other instrument to perforate the superficial nail and obtain material for culture.


An oral antifungal agent is usually needed (e.g. terbinafine or itraconazole). See onychomycosis.


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