A look into…Onychomycosis

Onychomycosis refers to a fungal infection of the nail which can occur on the hands or feet, but in most western countries more commonly occurs on the toenail. The infection is mostly found in males and can be caused by fungi known as dermatophytes which feed on the nail tissue, yeast and non-dermatophyte molds. The two dermatophytes, Trichophyton rubrum and Trichophyton mentagrophytes, account for around 90% of all cases (country dependant).

The dermatophyte Trichophyton rubrum causes distal lateral subungual onychomycosis (DLSO), where the nail plate is thick and opaque, and proximal subungual onychomycosis (PSO), where an area of discolouration appears near the nail folding. Making these diagnoses is not easy as definitive diagnosis requires nail biopsy, histologic analysis and fungal culture to identify the causative agent and in addition many cases of onychomycosis are self-diagnosed. The Epiomic™ database sub-divides the clinically diagnosed patient population by both the causative agent (e.g. yeast) and the major clinical presentation type (e.g. PSO) in order to create a better understanding of the disease.

Recent figures show that diabetic patients are 2.8 times more likely to have onychomycosis than nondiabetic patients. Patients with diabetes often experience lack of pain sensation making them more susceptible as they are unaware of the developing infection on their foot. Additionally, tinea pedis often occurs alongside onychomycosis and it is vital that this is treated as the skin is the likely source of the pathogens which led to infection in the nail. The Epiomic™ database sub-divides the patient population by these co-morbidities in order to give a unique insight into a disease which is both hard to definitively diagnose and effectively treat.

Did you know ... The prevalence of onychomycosis in HIV-infected patients has been reported to be 30%, most likely as a result of immunosuppression.