Onychomycosis

Excerpt

Onychomycosis is a fungal infection of the nail unit and is among the most prevalent nail disorders encountered in clinical practice, often posing diagnostic and therapeutic challenges due to its diverse etiologies and chronic nature. When dermatophytes cause onychomycosis, this condition is called tinea unguium. The term onychomycosis encompasses dermatophyte, yeast, and saprophytic mold infections. Caused primarily by dermatophytes, eg, Trichophyton rubrum, and less frequently by yeasts and nondermatophytic molds, onychomycosis affects millions worldwide, leading to nail discoloration, thickening, and dystrophy. An abnormal nail not caused by a fungal infection is a dystrophic nail.

Onychomycosis can infect both fingernails and toenails, but onychomycosis of the toenail is much more prevalent. Despite advances in diagnostic tools and antifungal therapies, misdiagnosis and suboptimal management remain common, resulting in persistent infection and patient dissatisfaction. Therefore, an in-depth understanding of evidence-based strategies is vital to enhance diagnostic precision, therapeutic decision-making, and interprofessional coordination, thereby improving outcomes and preventing recurrence.