Onychomycosis

DIMITRIS RIGOPOULOS, MD, is Professor of Dermatology and Venereology at the Medical School, National and Kapodistrian University of Athens, Athens, Greece. BONI ELEWSKI, MD, is Professor and Chair of Dermatology at the University of Alabama, Birmingham, AL, USA. BERTRAND RICHERT, MD, PhD, is Professor of Dermatology and Clinical Professor at Brugmann St Pierre and Queen Fabiola Children's University Hospitals, Université Libre de Bruxelles, Brussels, Belgium.

• List of Contributors vii1 The History of Onychomycosis 1Bárður Sigurgeirsson 2 Epidemiology of Onychomycosis 13Mahmoud A. Ghannoum, Iman Salem, and Luisa Christensen 3 Tinea Pedis and Onychomycosis 21David de Berker 4 Clinical Features: Classification  31Roderick J. Hay 5 Grading Onychomycosis 41Anna Q. Hare and Phoebe Rich 6a Routine and Emerging Techniques in Onychomycosis DiagnosisShari R. Lipner, Richard K. Scher, and Adam I. Rubin 476b Histopathology of Onychomycosis 60Josette André 6c Dermoscopy in the Diagnosis of Onychomycosis 66Bianca Maria Piraccini, Aurora Alessandrini, Francesca Bruni, and Michela Starace 7 Differential Diagnosis of Onychomycosis 75Dimitris Rigopoulos and Bertrand Richert 8 Predicting the Outcome of Treatment: Prognostic Factors  83Bárður Sigurgeirsson 9a Topical Therapies for Onychomycosis 103Casey Wang, Theresa Canavan, and Boni Elewski9b Systemic Treatment of Onychomycosis 118Austin John Maddy and Antonella Tosti9c(i) Laser Devices in the Treatment of Onychomycosis  123Dimitris Rigopoulos, Christos Prevezas, and Ioanna Triantafyllopoulou9c(ii) Photodynamic Therapy (PDT) in the Treatment of Onychomycosis  133Elena Sotiriou and Dimitris Ioannides9c(iii) Onychomycosis and Iontophoresis 141Avner Shemer9c(iv) Nail Drilling 146Pauline Lecerf9d Physical Treatment of Onychomycosis 150Bertrand Richert9e Onychomycosis: Algorithm 160Bertrand Richert9f Prevention of Relapse and Re‐Infection: Prophylaxis  162Eckart Haneke10 Future Treatments for Onychomycosis  173Aditya K. Gupta and Sarah G. Versteeg11 Onychomycosis in Special Populations 187Nilton Di Chiacchio and Nilton Gioia Di Chiacchio12 Onychomycosis: The Podiatric Physician Perspective  197Lauren Dabakaroff, Tyrone A. Mayorga, and Bryan C. Markinson13 Home Remedies for Onychomycosis 207Jane S. Bellet and C. Ralph Daniel, IIIIndex 213

DescriptionOnychomycosis probably has more "treatments" than virtually any other dermatological condition. Why? Because there isn't any one treatment that is 100% effective or even works the majority of the time, even when using it for a year! Fungal nail infections are inherently frustrating to cure and have always been a difficult and often impossible endeavor for dermatologists. This book covers every imaginable treatment, including those with little supporting data (the authors state this when it applies).PurposeThe purpose is to educate dermatologists on all current approaches that are available for treating onychomycosis. Limitations and risks of each therapy are reviewed.AudienceThe audience is dermatologists.FeaturesLaser, topical, and systemic medications, surgery, and home topical remedies are all discussed. There are numerous photographs, but, unfortunately, most are not in color. There is a therapeutic algorithm for guiding readers in choosing a reasonable treatment path based on clinical presentation and prior drugs used.Tables listing criteria for a surgical approach, oral antifungal medications, and predisposing medical illness that contribute to making clearance more problematic are helpfully included. There are photographs showing clinical appearance of infected toenails from different dermatophtyes and nondermatophyte molds. Tips for using the dermatoscope for confirming onychomycosis are discussed. Surgical debridement is covered in detail. One would be able to perform the procedure after reading the book.AssessmentThis is the definitive book on diagnosing and treating onychomycosis. The latest research and practical expertise from experts specializing in onychomycosis are neatly presented in one package. Other books do not cover the subject as extensively—onychomycosis is generally tacked on as a chapter in a nail disorder book."This is the definitive book on diagnosing and treating onychomycosis."—Patricia Wong, MD, Stanford University Medical Center (Doody's Review Service)