17: Onychomycosis and Other - Milles Flashcards

1
Q

definitions

onychomycosis

dermatophytes

tinea unguium

A
  • nail infection caused by any fungus
  • fungi that require keratin for growth which cause supeficial infections of nails (and also skin and hair) in humans and in animals
  • clinical term for dermatophytic onychomycosis
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2
Q

common cause of distal subungual onychomycosis

A

trychopyton rubrum

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3
Q

proximal subungual onychomycosis should always prompt …

A

HIV testing

  • occurs in severely immunocompromised patients
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4
Q

differential diagnosis for brown-black discoloration of nial plate in diffuse, linear, or localized pattern with or without nail dystrophy

A
  • fungal melanonychia
  • racial longitudinal melonynchia
  • melanoma *!*
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5
Q

nail dystrophy in the elderly in which the nail becomes thickened and curved

A

senile ischemia (onychogryphosis)

  • caused by ill-fitting shoes and/or vascular disease
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6
Q

most sensitive and specific diagnostic test for nail fungus

A

PAS stain

  • results available in 24-48 hrs
  • stains fungal cell walls
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7
Q

trichophyton rubrum on saboraud’s medium

A
  • appears white and cototny with a red underside
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8
Q

most efficacious option for onychomycosis

A

terbenafine (oral)

  • 250 mg daily (based on weight) for 12 wks
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9
Q

safety concern with terninafine and itraconazole/fluconazole

A

all three medications can cause heaptotoxicity

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