Abstract
Podiatric physicians have a unique practice situation, as they generally manage onychomycosis cases on a daily basis and in a specialized population (diabetes, Chap. 17). However, toenail disease may be caused by a variety of issues that are specifically foot related and not fungal related: trauma from shoes, biomechanical issues and forces, and infection compounded by shoe gear and adjacent skin conditions to the nails (i.e., interdigital tinea pedis). It is important when discussing the management and treatment of toenail onychomycosis that the visually similar biomechanical causes of nail dystrophy are also mentioned.
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References
Hay RJ, Baran R. Onychomycosis: A proposed revision of the clinical classification. J Am Acad Dermatol. 2011;65:1219–27.
Faergemann J, Baran R. Epidemiology, clinical presentation and diagnosis of onychomycosis. Br J Dermatol. 2003;149(Suppl):1–4.
Murphy F, Jiaravuthisan MM, Sasseville D, et al. Psoriasis of the nail: anatomy, pathology, clinical presentation, and review of the literature on therapy. J Am Acad Dermatol. 2007;57(1):1–27.
Rich P, Elewski B, Scher RK, et al. Diagnosis, clinical implications, and complications of onychomycosis. Semin Cutan Med Surg. 2013;32(2Suppl 1):S5–8.
Moll JM. Seronegative arthropathies in the foot. Baillieres Clin Rheumatol. 1987;1(2):289–314.
Fletcher CL, Hay RJ, Smeeton NC. Onychomycosis: the development of a clinical diagnostic aid for toenail disease. Part I. Establishing discriminating historical and clinical features. Br J Dermatol. 2004;150:701–5.
Weinberg JM, Koestenblatt EK, Tutrone WD, et al. Comparison of diagnostic methods in the evaluation of onychomycosis. J Am Acad Dermatol. 2003;49(2):193–7.
Reisberger E-M, Abels C, Landthaler M, et al. Histopathological diagnosis of onychomycosis by periodic acid-Schiff-stained nail clippings. Br J Dermatol. 2003;148(4):749–54.
Borkowski P, Williams M, Holewinski J, et al. Onychomycosis: an analysis of 50 cases and a comparison of diagnostic techniques. J Am Podiatr Med Assoc. 2001;91(7):351–5.
Elewski BE. Diagnostic techniques for confirming onychomycosis. J Am Acad Dermatol. 1996;35:56–60.
Arca E, Saracli MA, Akar A, et al. Polymerase chain reaction in the diagnosis of onychomycosis. Eur J Dermatol. 2004;14:52–5.
Pierard GE, Arrese-Estrada J, Pierard-Franchimont C. Treatment of onychomycosis: traditional approaches. J Am Acad Dermatol. 1993;29:S41–5.
Spreadbury C, Holden D, Aufaurre-Brown A, et al. Detection of aspergillus fumigatus by polymerase chain reaction. J Clin Microbiol. 1993;31:615–21.
Miyakawa Y, Mabuchi T, Kagaya K, et al. Isolation and characterization of a species-specific DNA fragment for detection of Candida albicans by polymerase chain reaction. J Clin Microbiol. 1992;30:894–900.
Baharaeen S, Vishniac HS. 25S ribosomal RNA homologies of basidiomycetous yeasts: taxonomic and phylogenetic implications. Can J Microbiol. 1984;30:613–21.
Walberg M, Mørk C, Sandven P, et al. 18S rDNA polymerase chain reaction and sequencing in onychomycosis diagnostics. Acta Derm Venereol. 2006;86:223–6.
Potter LP, Mathias SD, Raut M, et al. The impact of aggressive debridement used as an adjunct therapy with terbinafine on perceptions of patients undergoing treatment for toenail onychomycosis. J Dermatolog Treat. 2007;18:46–52.
Malay DS, Yi S, Borowsky P, et al. Efficacy of debridement alone versus debridement combined with topical antifungal nail lacquer for the treatment of pedal onychomycosis: a randomized, controlled trial. J Foot Ankle Surg. 2009;48:294–308.
Jennings MB, Pollak R, Harkless LB, et al. Treatment of toenail onychomycosis with oral terbinafine plus aggressive debridement: IRON-CLAD, a large, randomized, open-label, multicenter trial. J Am Podiatr Med Assoc. 2006;96:465–73.
Vlahovic TC, Joseph WS, Scher RK, Tosti A, Plasencia J, Pariser DM, Markinson BC. Diagnosis and management of onychomycosis: perspectives from a joint podiatry-dermatology roundtable. J Am Podiatr Med Assoc. 2016;106(2):155–62.
Gupta AK, Paquet M, Simpson FC. Therapies for the treatment of onychomycosis. Clin Dermatol. 2013;31(5):544–54.
Grover C, Bansal S, Nanda S, et al. Combination of surgical avulsion and topical therapy for single nail onychomycosis: a randomized controlled trial. Br J Dermatol. 2007;157(2):364–8.
Pandhi D, Verma P. Nail avulsion: Indications and methods (surgical nail avulsion). Indian J Dermatol Venereol Leprol. 2012;78:299–308.
Daniel CR 3rd, Tosti A, Iorizzo M, Piraccini BM. The disappearing nail bed: a possible outcome of onycholysis. Cutis. 2005;76(5):325–7.
Allevato MAJ. Diseases mimicking onychomycosis. Clin Dermatol. 2010;28:164–77.
Bodman MA. Nail Dystrophies. Clin Podiatr Med Surg. 2004;21(4):663–87. viii
Zaiac MN, Daniel CR. Nails in systemic disease. Dermatol Ther. 2002;15(2):99–106.
Zaias N, Rebell G, Casal G, Appel J. The asymmetric gait toenail unit sign. Skinmed. 2012;10(4):213–7.
Zaias N, Rebell G, Escovar S. Asymmetric gait nail unit syndrome: the most common worldwide toenail abnormality and onychomycosis. Skinmed. 2014;12(4):217–23.
Vlahovic TC, Schleicher SM. “Nail disorders” in skin disease of the lower extremities: a photographic guide, HMP Communications, 2012.
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Vlahovic, T.C. (2017). The Podiatric Approach. In: Tosti, A., Vlahovic, T., Arenas, R. (eds) Onychomycosis. Springer, Cham. https://doi.org/10.1007/978-3-319-44853-4_19
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