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Dystrophic Onychomycosis

A chronic fungal infection affecting most of the nail with marked deformation.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Dermatoloji department. Book Appointment →

What is Dystrophic Onychomycosis?

Total dystrophic onychomycosis is the advanced and most severe form of nail fungal infections. The nail plate is almost entirely thickened, distorted, yellowed, or darkened. It is usually the result of the natural course of long-untreated dermatophyte infections.

The condition is caused by dermatophytes, primarily Trichophyton rubrum; in immunocompromised patients, Candida species and non-dermatophyte molds may also be causative. Diabetes mellitus, peripheral vascular disease, and immunosuppression are risk factors.

Treatment is difficult and prolonged. In addition to systemic antifungal therapy, a combination of nail avulsion, topical treatment, and mechanical thinning is used in some cases. Recurrence rate is high.

Symptoms

Marked thickening of the nail
Yellow-brown or gray discoloration
Crumbling and destruction of the nail plate
Toenail deformity
Pain and difficulty wearing shoes
Odor of secondary bacterial infection
Concomitant tinea pedis

Risk Factors

Diabetes mellitus
Peripheral vascular disease
Immunosuppression
Long-term untreated tinea pedis
Advanced age
Family history of onychomycosis

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • If the nail is markedly thickened and you have trouble wearing shoes
  • If you have diabetes and the nails are worsening
  • If there is pain or accompanying infection
  • If there is no response to topical treatments
  • If multiple nails are affected

Treatment Methods

01
Systemic antifungal (terbinafine or itraconazole)
02
Topical ciclopirox, efinaconazole, tavaborole
03
Mechanical thinning of the nail
04
Surgical or chemical avulsion in selected cases
05
Treatment of concomitant tinea pedis
06
Appropriate footwear, breathable socks, foot hygiene

Which Department to Visit?

You can visit our Dermatoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.