Help Notes for Nurses No. 1 -- Infections and Deformities of Toenails

What is Onychomycosis?

• Onychomycosis is an infection of toenails or fingernails associated with fungi or molds.

Why does Onychomycosis need nurses' attention?

• Onychomycosis may lead to big medical problems as well as reduce a person's quality of life. Its fungal lesions may spread to other places in the body including the scalp and skin. Some of these legions are contagious.

• "Onychomycosis is the most common nail disorder in adults. It is four to seven times more frequent in toenails, where it often involves several nails. It is a progressive disease

• In the "Foot-Check-Study within the European Achilles project, it's prevalence rate in Germany was found to be 12.4%.

What are its core features?

• Onychomycosis is a progressive disease most likely to be found among adults, and often involves several toenails.

• Often the nail plate is discolored, and as the the the disease progresses it might be lost altogether as the nail plate becomes detached from the nail bed.

To what deeper disease conditions might Onychomycosis point?

• Onychomycosis is a predictor for development of diabetic foot syndrome and foot ulcer.

What are some its predisposing factors?

• Diabetes mellitus is one of its disposing factors.

What are the available treatment strategies?

• Treatment strategy is mostly involve oral and topical therapies, with the former tending to be more effective. New drugs are being developed and some are are undergoing clinical trials. A key problem is the difficulty of nail permeation by drugs.

• Thus attentive caring for skin and nail disorders is important to inhibit problems developing in deeper structures of the foot.

• The most common topical application is ciclopirox (8% nail lacquer). This has limited effectiveness; yet the development of more in effective applications has proven to be a challenge.


• Daniel RC. Onychomycosis: burden of disease and the role of topical antifungal treatment. . J Drugs Dermatol. 2013 Nov;12(11):1263-6. (Abstract retrieved at

• Del Rosso JQ. The role of topical antifungal therapy for onychomycosis and the emergence of newer agents. J Clin Aesthet Dermatol. 2014 Jul;7(7):10-8. (Full article retrieved at

• Elewski BE, Rich P, Tosti A, Pariser DM, Scher R, Daniel RC, Gupta AK. Onchomycosis: an overview. J Drugs Dermatol. 2013 Jul 1;12(7):s96-103. (Abstract retrieved at

• Elsayed MM. Development of topical therapeutics for management of onychomycosis and other nail disorders: A pharmaceutical perspective. J Control Release. 2014 Dec 4. pii: S0168-3659(14)00765-2. doi: 10.1016/j.jconrel.2014.11.017. (Abstract retrieved at

• Kumar S, Kimball AB. New antifungal therapies for the treatment of onychomycosis. Expert Opin Investig Drugs. 2009 Jun;18(6):727-34. doi: 10.1517/13543780902810352 . (Abstract retrieved at

• Nenoff P, Ginter-Hanselmayer G, Tietz HJ.. Fungal nail infections--an update: Part 1--Prevalence, epidemiology, predisposing conditions, and differential diagnosis. Hautarzt. 2012 Jan;63(1):30-8. doi: 10.1007/s00105-011-2251-5. (Abstract retrieved at


  • Reference texts are copied verbatim from their sources.

  • If you or your organization would like to have a more detailed report, please contact

  • About infections and deformities of nails

A Help Note for Nurses

by Foot Care Academy


© 2014 by Foot Care Academy, all rights reserved

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