What is onychomycosis?

• Onychomycosis is a chronic fungal infection of the nail bed • Usually starts with tinea pedis • Response very poor to topical antifungals • Most common type is distal subungual onychomycosis Thickened nail, subungual fragments, and dissociation of the nail plate from nail bed • Usually caused by dermatophyte Trichophyton rubrum • Superficial white onychomycosis (SWO) is less common and may respond to topical therapy • Proximal subungual onychomycosis (PSO) may herald immunosuppression