Onychomycosis and Fungal Infections Flashcards

Which topical antifungal agent is approved for mild-to-moderate onychomycosis of the toenails?

Answer: Efinaconazole 10% solution (Jublia)

Efinaconazole 10% solution is an FDA-approved topical azole antifungal indicated for distal-lateral subungual onychomycosis caused by Trichophyton rubrum and T. mentagrophytes.

The risk of onychomycosis is significantly increased in patients with:

Answer: Diabetes mellitus, peripheral arterial disease, and immunosuppression

Compromised immune function, impaired circulation (diabetes, PAD), and reduced skin integrity all increase susceptibility to dermatophyte and Candida nail infections.

Total dystrophic onychomycosis (TDO) involves:

Answer: Destruction of the entire nail plate and nail bed

TDO represents the end stage of any onychomycosis subtype, with complete nail plate involvement, destruction, and significant subungual hyperkeratosis.

Candidal onychomycosis most commonly affects:

Answer: Fingernails and is frequently associated with chronic paronychia and moist environments

Candida species primarily affect fingernails, especially in individuals whose hands are frequently wet (food handlers, healthcare workers), and often coexist with chronic paronychia.

Before applying a nail brace to a nail suspected of having onychomycosis, the technician should:

Answer: Thoroughly debride the nail, treat with antifungal, and ensure adhesion surface is clean and dry

Subungual debris and fungal material prevent brace adhesion; debridement and antifungal preparation are necessary before brace placement.

The SCIO (Scoring Clinical Index for Onychomycosis) helps clinicians:

Answer: Objectively grade onychomycosis severity to guide treatment decisions

Severity indices like OSI (Onychomycosis Severity Index) and similar tools assess degree of nail involvement, helping guide choice between topical and systemic antifungal therapy.