Derm: Fungal nail infections: Free MSRA Podcast

⚕️ FREE MSRA PODCAST – Fungal Nail Infections (Onychomycosis) Demystified🦶 Your high-yield, no-fluff guide to diagnosing and managing onychomycosis in UK clinical practice and for MSRA revision!🧠 Key Learning Points📌 Definition• Fungal infection of the nail unit (mostly toenails), causing thickening, discolouration (yellow, brown, white), brittleness, and possible pain.📌 Causes & Risk Factors• Dermatophytes (esp. Trichophyton rubrum), yeasts (Candida), non-dermatophyte moulds• Key risk factors: Older age, Lifestyle (sports, communal bathing), Diabetes, Trauma, Immunocompromised, Moist environments, Existing skin infection (tinea pedis), Shared items (mnemonic: OLD TIMES)📌 Pathophysiology• Fungus invades the nail plate via cracks/skin, multiplies under nail, causing classic nail changes• Commonest subtype: Distal and lateral subungual• Others: Superficial white, proximal subungual, total dystrophic📌 Clinical Features• Discoloured, thick, crumbly nails• May lift from nail bed (onycholysis)• Not always painful, but can impair function and confidence📌 Differential Diagnoses• Psoriasis (esp. with skin plaques), lichen planus, trauma, eczema, bacterial infections (e.g. Pseudomonas – green), subungual melanoma (don’t miss!), yellow nail syndrome, thyroid disease📌 Diagnosis• Confirm by lab: Nail clippings/scrapings for microscopy, culture (PCR sometimes used)• Dermatophyte: Either microscopy OR culture +ve• Candida: BOTH microscopy AND culture +ve• Non-dermatophyte moulds: BOTH +ve, ideally 2 samples• Sample from deepest part of affected nail📌 Management• Only treat if functionally/cosmetically troublesome• First line: Oral terbinafine (fingers: 6 weeks–3 months; toes: 3–6 months)• Alternatives: Oral itraconazole (esp. for Candida), topical lacquers for mild/SWO• Self-care: Good foot hygiene, keep nails trimmed, treat tinea pedis, avoid shared nail tools, breathable shoes• Refer if: diagnosis unclear, fails treatment, needs surgery, immunosuppressed, extensive/recurrent cases📌 Complications• Permanent nail damage/loss, secondary bacterial infection (risk of cellulitis/osteomyelitis in diabetics/elderly), pain, psychosocial impact📌 Prognosis• Many cases can be cured, but success not 100%; nail takes months to regrow• Prevention: hygiene, treat athlete’s foot, avoid trauma📎 More MSRA Resources for Fungal Nail Infections📝 Revision Notes: https://www.passthemsra.com/topic/fungal-nail-infections-revision-notes/🧠 Flashcards: https://www.passthemsra.com/topic/fungal-nail-infections-flashcards/💬 Accordion Q&A: https://www.passthemsra.com/topic/fungal-nail-infections-accordion-qa-notes/🚀 Rapid Quiz: https://www.passthemsra.com/topic/fungal-nail-infections-rapid-quiz/🧪 Topic Quiz: https://www.passthemsra.com/quizzes/fungal-nail-infections/🎓 Dermatology Course: https://www.passthemsra.com/courses/dermatology-for-the-msra/🌍 Explore 1,000s more free & premium revision tools at:👉 https://www.passthemsra.com#MSRA #FungalNailInfections #Onychomycosis #Dermatology #MSRAFlashcards #MSRAQuiz #MSRAQandANotes #MSRAAccordions #MSRARevisionNotes #MSRATextbook #MSRAOnlineRevision #PassTheMSRA #FreeMSRA