Onychomycosis

Diagnosis and Effective Management

Dimitris Rigopoulos, Boni Elewski, Bertrand Richert, Dimitris Rigopoulos, Boni Elewski, Bertrand Richert

• Publisher: Wiley-Blackwell
• Year: 2018
• ISBN:
  9781119226505
• Edition: 1
• Topic: Medicine
• Subtopic: Dermatology

The definitive guide to one of the world's most prevalent dermatologic conditions

Onychomycosis is a fungal nail disease that accounts for 40% of all nail disorders, affecting 1 out of 10 people at some stage in their lives. Compiled by leading dermatologists with expert knowledge of the condition, Onychomycosis: Diagnosis and Effective Management provides a clear and clinically focused reference tool for those looking to treat patients expediently and successfully.

This in-depth guide covers all aspects of disease management, from differential diagnosis and lab analysis to topical and systemic treatments. Designed to be a functional and accessible resource, the text also highlights key learning points, with real-life case studies and helpful take-home messages included in each chapter. Coverage of recent innovations and cutting-edge methods ensure the content is relevant to today's dermatologists, while thorough explanations of routine techniques, prognostic factors, and epidemiology make this is an excellent handbook for anyone studying the disease for the first time. The book features:

• A complete guide to the diagnosis and treatment of this common disorder
• Key learning points, case studies, and take-home messages to aid quick and easy consultation
• Insights from world-renowned dermatological experts from North America and Europe
• Over 70 illustrations

Onychomycosis is a reliable, easy-to-use companion for trainees and experienced specialists alike, and an invaluable asset to any clinic treating nail conditions.

1
The History of Onychomycosis

Bárður Sigurgeirsson

Department of Dermatology, Faculty of Medicine, University of Iceland, Reykjavík, Iceland

1.1 Introduction

The modern history of medical mycology is relatively short (Table 1.1). It was Agostino Bassi (1773–1856) who in 1836 described the muscardine disease of silkworms which was caused by a fungus that would be named eventually Beauveria bassiana in his honor [1]. The clinical aspects of dermatomycoses have been known for a much longer time. Aulus Cornelius Celsus (c. 25 BC to c. 50 AD) recognized inflammatory tinea and described the first kerion celsi, a name still used today [2]. At that time, no microscopic knowledge existed and therefore the study of diseases was purely based on clinical findings. Favus and sycosis were already known in ancient times (the word means tinea in Egyptian).

Table 1.1 Early development of medical mycology and onychomycosis.

Year	Author	Comment	References
1835	Bassi	Discovers that muscardine disease of silkworms is caused by a fungus	[1]
1837	Remak	Observes microscopic structures appearing as rods and buds in crusts from favic lesions. Does not publish his observations, but allows his findings to be cited in a doctoral thesis of Xavier Hube	Not published [3]
1839	Schönlein	Communicates the fungal nature of dermatomycoses	[4]
1841–1844	Gruby	Unware of Remek’s and Schönlein’s findings, he describes clinical and microscopic characteristics of the causative agent of favus	[5–8]
1853	Meissner	Discovers that onychomycosis is caused by fungi	[9]
1854	Virchow	First to use the name onychomycosis for this new disease	[10]

Johannes Schönlein was the first to understand the fungal nature of dermatomycoses [4]. Sabouraud began his scientific studies of the dermatophytes around 1890, culminating in the publication of his classic volume, Les Teignes, in 1910 [11]. No specific antifungal drugs existed until after World War II.

1.2 The History and Discovery of Onychomycosis

A German medical student, Georg Meissner (19 November 1829 to 30 March, 1905) was the first to describe the fungal nature of onychomycosis in 1853 (Figure 1.1) [9]. It was Meissner later who became famous for discovering the tactile instrument of the skin (Meissner’s corpuscle). Meissner described accurately both the clinical and mycological form of onychomycosis [9]. He also included drawings of the clinical appearance of the disease (Figure 1.2). He described how he softened the nail by using sodium hydroxide, and it is important that to remember that at that time microscopes were still very simple and dyes were not used. Meissner also described and drew filamentous fungi and spores (Figure 1.3).

Figure 1.1 The first page from Meissner’s paper where he describes his discovery of the fungal nature of onychomycosis.

Figure 1.2 Meissner...

Table of contents

• Cover
• 1 The History of Onychomycosis
• 2 Epidemiology of Onychomycosis
• 3 Tinea Pedis and Onychomycosis
• 4 Clinical Features
• 5 Grading Onychomycosis
• 6a Routine and Emerging Techniques in Onychomycosis Diagnosis
• 6b Histopathology of Onychomycosis
• 6c Dermoscopy in the Diagnosis of Onychomycosis
• 7 Differential Diagnosis of Onychomycosis
• 8 Predicting the Outcome of Treatment
• 9a Topical Therapies for Onychomycosis
• 9b Systemic Treatment of Onychomycosis
• 9c(i) Laser Devices in the Treatment of Onychomycosis
• 9c(ii) Photodynamic Therapy (PDT) in the Treatment of Onychomycosis
• 9c(iii) Onychomycosis and Iontophoresis
• 9c(iv) Nail Drilling
• 9d Physical Treatment of Onychomycosis
• 9e Onychomycosis: Algorithm
• 9f Prevention of Relapse and Re‐Infection: Prophylaxis
• 10 Future Treatments for Onychomycosis
• 11 Onychomycosis in Special Populations
• 12 Onychomycosis
• 13 Home Remedies for Onychomycosis
• Index
• End User License Agreement