Fungal Nail Infections (Onychomycosis)

Question 1

What causes onychomycosis?

Answer 1

90% caused by Tichophyton rubrum

Rest:

Yeasts (Candida) and Non-dermatophyte moulds

Question 2

What is your treatment pathway for onychomycosis?

Answer 2

• Diagnosis should be confirmed by microbiology before starting treatment
• Dermatophyte infection:
  
  • First line - oral Terbinafine
    
    • Finger nails treat for 6 weeks to 3 months.
    • Toenails - treat for 3 to 6 months.
  • Second line - Oral itraconazole
• Candida infection:
  
  • ​Mild disease - Topical antifungals (e.g. Amorolfine)
  • Severe infections - Oral itraconazole for a period of 12 weeks

Question 3

Treatment is succesful in what percentage of people?

Answer 3

Treatment is successful in around 50-80% of people