F ungal infections of the nail are increasing in frequency, particularly in the older population. Infections may present in a variety of ways, and may mimic many other nail abnormalities. Proper diagnosis is essential for effective treatment of a nail condition. The following photographs depict nail presentations, which you may encounter regularly in your office. Test your knowledge of the following conditions. Case #1 Diagnosis:___________________________________________________ 1. This is a clinical presentation of total dystrophic onychomycosis. T__ F__ 2. Some of the main features in the nail include pitting, nail discoloration and onycholysis. T__ F__ 3. This condition may respond to intralesional corticosteroid therapy. T__ F__ 4. This condition may affect other areas of the body. T__ F__ Case #2 Diagnosis:___________________________________________________ 1. This condition primarily involves the great toenail. T__ F__ 2. This disorder is not associated with aging. T__ F__ 3. This condition can be clinically mimicked by onychomycosis. T__ F__ 4. The abnormal nail growth is initially in the lateral direction. T__ F__ 5. Clinically, the nail is uneven and thickened with multiple transverse striations. T__ F__ Case #3 Diagnosis:___________________________________________________ 1. This isn’t a common nail presentation. T__ F__ 2. This condition is normally confined to the fingernails. T__ F__ 3. The upper surface of the nail is the primary site of invasion. T__ F__ 4. This condition may be a clinical marker for immunodeficient patients. T__ F__ 5. This condition is secondary to paronychia. T__ F__ Case #4 Diagnosis:___________________________________________________ 1. This is a common presentation of onychomycosis. T__ F__ 2. The disease invades the distal nail bed via the hyponychium. T__ F__ 3. The most common causative organism is Trichophyton rubrum. T__ F__ 4. The nail plate-nail bed attachment remains unaffected. T__ F__ 5. The disease remains at the distal portion of the nail bed. T__ F__ Case #5 Diagnosis:___________________________________________________ 1. The nail detaches from the nail bed at the distal and/or lateral portion. T__ F__ 2. This condition can result from a splinter under the nail. T__ F__ 3. Lateral edge involvement is more common. T__ F__ 4. The free edge of the nail, in some cases, rises up like a hood. T__ F__ 5. Secondary infection by bacteria and yeast is not uncommon. T__ F__
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Isn’t It AlwaysOnychomycosis?A Self-Assessment Quiz
F ungal infections of the nail are increasing in frequency, particularly in the older population. Infections may present in a variety of ways, and may mimic many other nail abnormalities. Proper diagnosis is essential for effective treatment of a nail condition. The following photographs depict nail presentations, which you may encounter regularly in your office. Test your knowledge of the following conditions. Case #1 Diagnosis:___________________________________________________ 1. This is a clinical presentation of total dystrophic onychomycosis. T__ F__ 2. Some of the main features in the nail include pitting, nail discoloration and onycholysis. T__ F__ 3. This condition may respond to intralesional corticosteroid therapy. T__ F__ 4. This condition may affect other areas of the body. T__ F__ Case #2 Diagnosis:___________________________________________________ 1. This condition primarily involves the great toenail. T__ F__ 2. This disorder is not associated with aging. T__ F__ 3. This condition can be clinically mimicked by onychomycosis. T__ F__ 4. The abnormal nail growth is initially in the lateral direction. T__ F__ 5. Clinically, the nail is uneven and thickened with multiple transverse striations. T__ F__ Case #3 Diagnosis:___________________________________________________ 1. This isn’t a common nail presentation. T__ F__ 2. This condition is normally confined to the fingernails. T__ F__ 3. The upper surface of the nail is the primary site of invasion. T__ F__ 4. This condition may be a clinical marker for immunodeficient patients. T__ F__ 5. This condition is secondary to paronychia. T__ F__ Case #4 Diagnosis:___________________________________________________ 1. This is a common presentation of onychomycosis. T__ F__ 2. The disease invades the distal nail bed via the hyponychium. T__ F__ 3. The most common causative organism is Trichophyton rubrum. T__ F__ 4. The nail plate-nail bed attachment remains unaffected. T__ F__ 5. The disease remains at the distal portion of the nail bed. T__ F__ Case #5 Diagnosis:___________________________________________________ 1. The nail detaches from the nail bed at the distal and/or lateral portion. T__ F__ 2. This condition can result from a splinter under the nail. T__ F__ 3. Lateral edge involvement is more common. T__ F__ 4. The free edge of the nail, in some cases, rises up like a hood. T__ F__ 5. Secondary infection by bacteria and yeast is not uncommon. T__ F__
F ungal infections of the nail are increasing in frequency, particularly in the older population. Infections may present in a variety of ways, and may mimic many other nail abnormalities. Proper diagnosis is essential for effective treatment of a nail condition. The following photographs depict nail presentations, which you may encounter regularly in your office. Test your knowledge of the following conditions. Case #1 Diagnosis:___________________________________________________ 1. This is a clinical presentation of total dystrophic onychomycosis. T__ F__ 2. Some of the main features in the nail include pitting, nail discoloration and onycholysis. T__ F__ 3. This condition may respond to intralesional corticosteroid therapy. T__ F__ 4. This condition may affect other areas of the body. T__ F__ Case #2 Diagnosis:___________________________________________________ 1. This condition primarily involves the great toenail. T__ F__ 2. This disorder is not associated with aging. T__ F__ 3. This condition can be clinically mimicked by onychomycosis. T__ F__ 4. The abnormal nail growth is initially in the lateral direction. T__ F__ 5. Clinically, the nail is uneven and thickened with multiple transverse striations. T__ F__ Case #3 Diagnosis:___________________________________________________ 1. This isn’t a common nail presentation. T__ F__ 2. This condition is normally confined to the fingernails. T__ F__ 3. The upper surface of the nail is the primary site of invasion. T__ F__ 4. This condition may be a clinical marker for immunodeficient patients. T__ F__ 5. This condition is secondary to paronychia. T__ F__ Case #4 Diagnosis:___________________________________________________ 1. This is a common presentation of onychomycosis. T__ F__ 2. The disease invades the distal nail bed via the hyponychium. T__ F__ 3. The most common causative organism is Trichophyton rubrum. T__ F__ 4. The nail plate-nail bed attachment remains unaffected. T__ F__ 5. The disease remains at the distal portion of the nail bed. T__ F__ Case #5 Diagnosis:___________________________________________________ 1. The nail detaches from the nail bed at the distal and/or lateral portion. T__ F__ 2. This condition can result from a splinter under the nail. T__ F__ 3. Lateral edge involvement is more common. T__ F__ 4. The free edge of the nail, in some cases, rises up like a hood. T__ F__ 5. Secondary infection by bacteria and yeast is not uncommon. T__ F__