By Antonella Tosti, Tracey C. Vlahovic, Roberto Arenas
There are an predicted 32 million individuals with onychomycosis within the usa on my own, making it the commonest nail illness noticeable and taken care of, but in addition particularly misunderstood. With the only concentration of this e-book dedicated to onychomycosis, the reader is supplied with perception into the analysis and administration of this nail an infection. Onychomycosis includes chapters on how fungus infects the nail unit, the kinds of nail fungus, prognosis from a gross and microscopic view, and a number of the therapies on hand. With chapters written by means of the world’s specialists besides dozens of top quality colour images and illustrations, this ebook is a realistic reference advisor for each dermatologist, podiatrist, and first care physician.
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Extra info for Onychomycosis: An Illustrated Guide to Diagnosis and Treatment
As with other techniques, it is key to identify fungi in the ventral nail plate. This method has high sensitivity and specificity, especially in the hands of an experienced histopathologist. In the current literature, several studies have investigated the applicability of these various diagnostic techniques. Generally, histopathological examination with PAS staining (HPE-PAS) is found to have the highest positive predictive value and negative predictive value and is regarded as the gold standard for diagnosis of onychomycosis [21, 22].
In endonyx, fungal hyphae infect and directly invade the superficial and deep portions of the nail plate . This unique pattern of nail invasion is conceivably related to these organisms’ high affinity for hard keratins . V. Shah, BA • A. edu © Springer International Publishing Switzerland 2017 A. Tosti et al. V. Shah and A. Tosti Epidemiology Endonyx onychomycosis appears to affect both men and women equally and is found among all age groups and ethnicities [1, 2, 6]. The exact incidence of this nail infection remains unknown; however, it is likely to be more prevalent in areas where Trichophyton species is endemic, such as in central and west Africa .
Clinicians should be aware of the presentation of this rare entity, as certain forms may be resistant to standard antifungal therapy . The presence of milky-white discoloration of the nail plate in the absence of hyperkeratosis and onycholysis suggests endonyx pattern . PAS staining for fungal elements confined to the nail plate may help validate the diagnosis . Consider treatment with standard topical and oral antifungals first, followed by combination therapy, chemical and/or surgical plate avulsion, or photodynamic therapy if the infection is difficult to treat.