Onychomycosis, also known as tinea unguium,[4] is a fungal infection of the nail.[2] Symptoms may include white or yellow nail discoloration, thickening of the nail, and separation of the nail from the nail bed.[2][3] Toenails or fingernails may be affected, but it is more common for toenails.[3] Complications may include cellulitis of the lower leg.[3] A number of different types of fungus can cause onychomycosis, including dermatophytes and Fusarium.[3] Risk factors include athlete's foot, other nail diseases, exposure to someone with the condition, peripheral vascular disease, and poor immune function.[3] The diagnosis is generally suspected based on the appearance and confirmed by laboratory testing.[2]

Other namesDermatophytic onychomycosis[1] tinea unguium[1]
A toenail affected by onychomycosis
SpecialtyInfectious disease
SymptomsWhite or yellow nail discoloration, thickening of the nail[2][3]
ComplicationsLower leg cellulitis[3]
Usual onsetOlder males[2][3]
CausesFungal infection[3]
Risk factorsAthlete's foot, other nail diseases, exposure to someone with the condition, peripheral vascular disease, poor immune function[3]
Diagnostic methodBased on appearance, confirmed by laboratory testing[2]
Differential diagnosisPsoriasis, chronic dermatitis, chronic paronychia, nail trauma[2]
TreatmentNone, anti-fungal medication, trimming the nails[2][3]
MedicationTerbinafine, ciclopirox[2]
PrognosisOften recurs[2]
Frequency~10% of adults[2]

Onychomycosis does not necessarily require treatment.[3] The antifungal medication terbinafine taken by mouth appears to be the most effective but is associated with liver problems.[2][5] Trimming the affected nails when on treatment also appears useful.[2]

There is a ciclopirox-containing nail polish, but there is no evidence that it works.[2] The condition returns in up to half of cases following treatment.[2] Not using old shoes after treatment may decrease the risk of recurrence.[3]

Onychomycosis occurs in about 10 percent of the adult population,[2] with older people more frequently affected.[2] Males are affected more often than females.[3] Onychomycosis represents about half of nail disease.[2] It was first determined to be the result of a fungal infection in 1853 by Georg Meissner.[6]

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