Onychomycosis is a fungal infection of the nail bed, nail plate or both. It is caused by dermatophytes, non-dermatophyte molds and yeast.
Tinea unguium or dermatophytic onychomycosis is a dermatophyte infection of the nail more commonly affecting the toenails than the fingernails.
It is usually asymptomatic and patients first consult for cosmetic reasons.
It is suspected if there are changes in the 3rd or 5th toenail, involvement of the 1st and 5th toenails on the same foot and unilateral nail changes.
Patients should wear breathable footwear & 100% cotton socks
Change socks often, if possible
Keep feet dry throughout the day, may use antifungal foot powder
Recognize & treat Tinea pedis to prevent spread to toenails
Patient should be encouraged to maintain & improve health conditions
Eg regularly trim nails short, control diabetes mellitus (DM), quit smoking, exercise, etc
Assure patient that improvement continues even after cessation of oral treatment since the fungus is continually exposed to the medication secondary to the drug’s binding to keratin in the nail, though recurrence is common
Routinely used for treating cardiovascular diseases, statins have been shown to benefit other conditions, and new evidence suggests that using the drug at high intensity reduces the risk of hip or knee replacement, an effect that may be specific to rheumatoid arthritis.
Having migraine during midlife appears to be associated with a higher risk of developing dementia in later life, according to a large population-based longitudinal Danish study presented at the AHS* 2020 Virtual Meeting, indicating that migraine may be a risk factor for dementia.
Pembrolizumab in combination with chemotherapy significantly improves progression-free survival (PFS) vs chemotherapy alone in patients with previously untreated, locally recurrent inoperable or metastatic triple-negative breast cancer (TNBC), results of the KEYNOTE-355 study have shown.