Nails as Dynamic, Not Static, Entities—Rethinking the Approach to Nail Disorders

Rana, Jasmine; Vlahovic, Tracey C.

doi:10.1001/jamadermatol.2024.0400

JAMA Dermatol

2024

DOI: 10.1001/jamadermatol.2024.0400

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Nails as Dynamic, Not Static, Entities—Rethinking the Approach to Nail Disorders

Jasmine Rana,

Tracey C. Vlahovic

Abstract: This Viewpoint discusses the need for a broader approach to nail pathology, in which infectious, inflammatory, systemic, and structural factors are considered.

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2024

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At-home technique for debridement of nail plate thickening

Axler,

Neubauer,

Lipner

2024

JAAD Case Reports

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At-home technique for debridement of nail plate thickening

Axler,

Neubauer,

Lipner

2024

JAAD Case Reports

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Patient Characteristics, Diagnostic Testing Utilization, and Antifungal Prescribing Pattern for Onychomycosis in the USA: A Cohort Study Using DataDerm, 2016–2022

Gupta,

Wang,

Tran

2024

Skin Appendage Disord

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Introduction: Onychomycosis is a complex nail disease that is commonly seen in daily practice. Methods: Electronic health records of clinically diagnosed onychomycosis patients were extracted using DataDerm – a dermatology data registry hosted by the American Academy of Dermatology – spanning from the year 2016 to 2022. Results: Regardless of age, an increasing trend in patient volume was observed in the Southern US region, which accounted for 50.7–56.9% of onychomycosis patients in 2022. A coinfection of tinea pedis was present among 15.6–22.5% of patients. Diagnostic testing was infrequently utilized with less than one-quarter of patients having a histopathologic examination (12.7–21.9%) followed by fungal culture (5.5–8.2%) and direct microscopic examination (3.3–6.0%). Treatments were infrequently prescribed, accounting for less than one-quarter of patients (orals, terbinafine: 20.8–29.1%, fluconazole: 12.9–16.5%; topicals, efinaconazole: 3.2–13.8%); over 30% of treated patients received a combination regimen or experienced switching of treatments. Prescribing patterns did not significantly differ in vulnerable patient groups such as elderly patients and in patients with concomitant tinea pedis. Patients receiving a topical and/or oral antifungal prescription were frequently not tested to confirm the onychomycosis diagnosis (76.9%). Conclusion: Our findings add to a growing body of literature calling for the improvement of onychomycosis management practices.

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Nails as Dynamic, Not Static, Entities—Rethinking the Approach to Nail Disorders

Abstract: This Viewpoint discusses the need for a broader approach to nail pathology, in which infectious, inflammatory, systemic, and structural factors are considered.

Cited by 2 publications

References 11 publications

At-home technique for debridement of nail plate thickening

At-home technique for debridement of nail plate thickening

Patient Characteristics, Diagnostic Testing Utilization, and Antifungal Prescribing Pattern for Onychomycosis in the USA: A Cohort Study Using DataDerm, 2016–2022

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