Onychomycosis

Onychomycosis

An infection of the nails caused by a fungus called onychomycosis affects 2-14% of the general population and can afflict nearly half of the senior population by the age of 70. Candida albicans, an ermatophyte, is the most frequent causal agent, accounting for less than 5% of infections. The talk that follows will only address toenail illness because the toenails (tineauguium) are the site of the bulk of infections.

The patient may express concern over the way their nails seem abnormally or they may express pain.

The nail appears opaque and white when examined closely. The distal portion of the nail may rise from the nail bed due to hyperkeratotic debris as the infection worsens, causing the nail to turn brown, thicken, and crack more easily.

Treatment

There are several treatments available if the patient complains of pain or that the infected nails are interfering with daily activities:

• Surgical debridement or avulsion of the nail. When paired with oral or topical medication, this type of therapy can be particularly successful. Only as a final resort should the nail be completely removed.
• Using one of the many topical antifungal medications that are available to treat onychomycosis. In most cases, topical medications need to be paired with surgical debridement or nail avulsion in order to be effective.
• Fluconazole, terbinafine, or itraconazole are only a few of the possibilities for oral medication. All three of these oral drugs are hepatotoxic, therefore regular monitoring of lever function tests is required.