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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Cited by 3 publications

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Use of the Brannock device to detect differences in foot length in patients with traumatic nail disease

Hill,

Axler,

Forman

et al. 2024

Journal of the American Academy of Dermatology

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Use of the Brannock device to detect differences in foot length in patients with traumatic nail disease

Hill,

Axler,

Forman

et al. 2024

Journal of the American Academy of Dermatology

View full text Add to dashboard Cite

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 3 publications

References 11 publications

Use of the Brannock device to detect differences in foot length in patients with traumatic nail disease

Use of the Brannock device to detect differences in foot length in patients with traumatic nail disease

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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