Diagnosis, Clinical Implications, and Complications of Onychomycosis

Rich, Phoebe MD
Elewski, Boni MD
Scher, Richard K. MD
Pariser, David MD

^* Clinical Adjunct Professor of Dermatology, Oregon Health Science University, Portland, OR
^† Vice-Chair for Clinical Affairs, Professor of Dermatology University of Alabama School of Medicine, Birmingham, AL
^‡ Clinical Professor of Dermatology, Weill Cornell Medical College New York, NY
^§ Professor of Dermatology, Eastern Virginia Medical School Department of Dermatology, Pariser Dermatology, Norfolk, VA

Publication of this CME article was jointly sponsored by the University of Louisville School of Medicine Continuing Medical Education and Global Academy for Medical Education, LLC and is supported by an educational grant from Medicis, a division of Valeant Pharmaceuticals.

The faculty have received an honorarium from Global Academy for Medical Education for their participation in this activity. They acknowledge the editorial assistance of Joanne Still, medical writer, and Global Academy for Medical Education in the development of this continuing medical education journal article. Joanne Still has no relevant financial relationships with any commercial interests.

Boni Elewski, MD, has been an investigator for Anacor and Valeant.

David Pariser, MD, has been a consultant and/or investigator and/or advisory board member with Abbott Laboratories, Amgen, Astellas Pharma US, Inc, Basilea, Celgene Corporation, Dow Pharmaceutical Sciences, Inc., DUSA Pharmaceuticals, Inc., Eli Lily and Company, Galderma Laboratories, L.P., Genentech, Inc., Graceway Pharmaceuticals, LLC, Intendis, Inc., Janssen-Ortho Inc, Johnson & Johnson Consumer Products Company, LEO Pharma, US, Medicis Pharmaceutical Corporation, MelaSciences, Novartis Pharmaceutical Corporation, Novo Nordisk A/S, Ortho Dermatologics, Peplin Inc., Pfizer, Photocure ASA, Proctor & Gamble Company, Stiefel a GSK company, and Valeant Pharmaceuticals International.

Phoebe Rich, MD, has been a principal investigator and/or consultant for Valeant, Dow Pharmaceuticals, Topica, and Tolmar.

Richard K. Scher, MD, is an advisor/consultant to Valeant.

Address reprint requests to: Phoebe Rich, MD, 2565 NW Lovejoy Street, Suite 200, Portland, OR 97210, Telephone: (503) 226-3376, E-mail: [email protected]

Seminars in Cutaneous Medicine & Surgery 32(2):p S5-S8, June 2013.

ABSTRACT The diagnosis of onychomycosis is suggested by the clinical presentation as well as the family history and patient age. The definitive diagnosis of onychomycosis is based on (1) establishing the presence or absence of fungal elements using laboratory methods and/or (2) identifying the fungus using fungal culture or, in the future, by polymerase chain reaction as new developments emerge in this technology, making more widespread application of this technique possible.