Onychomycosis

Question 1

What are some patient factors in onychomycosis warrant a referral to an MD?

Answer 1

Under 18
First episode
Immunocompromised
Diabetes
Other comorbidities
History of trauma
Pitting of the nail
Drug implicated with nail disorders

Question 2

What are some red flags in onychomycosis?

Answer 2

More than 3 nails affected

More than 50% of individual nail involvement

Lunula involvement

Onycholysis

Question 3

What are some symptoms typical of mild distal lateral subungal onychomycosis?

Answer 3

Thickened, brittle, crumbing nails

Starts at distal tip and spreads laterally

White, yellow, or brown debris on the underside of nails

Yellow/white or orange/brown coloured streaks

Patient may have pain or discomfort

Question 4

What are some treatment options for onychomycosis?

Answer 4

Non-pharmacological: Keep clean, change socks

OTC: propylene glycol/urea/lactic acid topical solution

Rx: Efinconazle 10% once daily x 48 weeks