Onychomycosis and Fungal Infections Flashcards

Oral terbinafine is preferred over oral itraconazole for onychomycosis because:

Answer: It is fungicidal and has fewer drug interactions than itraconazole

Terbinafine is fungicidal (kills fungi) rather than fungistatic (inhibits growth) and has a superior safety profile with fewer cytochrome P450 drug interactions compared to itraconazole.

How long after completing systemic antifungal treatment may full clinical cure of toenail onychomycosis take?

Answer: 12–18 months (time for full toenail replacement)

Toenails grow at approximately 1.5 mm/month; full replacement of a healthy nail plate after antifungal treatment takes 12–18 months, so clinical cure is assessed at that time.

Which infection control measure is most important to prevent onychomycosis transmission between patients?

Answer: Using single-use instruments or sterilized instruments between every patient

Dermatophytes are readily transmitted via contaminated instruments; sterilization or single-use disposables between patients is the primary prevention measure.

Recurrence of onychomycosis after successful treatment is most commonly due to:

Answer: Re-infection from environmental sources (shoes, floors, shared facilities) and residual fungal reservoirs

High recurrence rates (up to 50% in 5 years) are mainly due to re-exposure from contaminated footwear, communal bathing areas, and persistence of fungal reservoirs in the skin.

Enilconazole (Imaverol) in nail fungal management is primarily used as:

Answer: A topical antifungal applied under occlusion to softened nail tissue

Enilconazole is an imidazole antifungal used topically; application under occlusion (covering with a dressing) enhances penetration through the softened nail plate.

Green nail syndrome (Chloronychia) is caused by infection with:

Answer: Pseudomonas aeruginosa

Green nail syndrome results from Pseudomonas aeruginosa colonization of the onycholytic space, producing pyocyanin and other pigments that stain the nail green.