Curling toenails, Subclinical onychomycosis and fungal toenails ZENIP20032024 2011

Curved toenails, Be careful to separate the ingrown toenails Onychomycosis is suspected by appearance in patients who also have tinea pedis; predictive clinical features include involvement of the 3rd or 5th toenail, involvement of the 1st and 5th toenails on the same foot, and unilateral nail deformity. Subclinical onychomycosis should be considered in patients with recurrent tinea pedis. Differentiation from psoriasis or lichen planus is important because the therapies differ, so diagnosis is typically confirmed by microscopic examination and, unless microscopic findings are conclusive, culture of scrapings or PCR of clippings. Scrapings are taken from the most proximal position that can be accessed on the affected nail and are examined for hyphae on potassium hydroxide wet mount and cultured. Although more expensive, PCR has become a more common technique to confirm the diagnosis of onychomycosis, especially if cultures are negative or a definitive diagnosis is required (1, 2, 3). Histopathologic