Abstract

ONYCHOMYCOSIS INSIGHTS INTO PATHOGENESIS, DIAGNOSTIC APPROACHES, AND EVOLVING TREATMENT STRATEGIES

*Rupali Pawar, Shailesh Pawar, Prem Pokale, Yash Chavhan, Anand Kamble, Dr. Rahul Bijwar

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Abstract

A large percentage of people worldwide suffer from onychomycosis, a prevalent chronic fungal infection of the nail unit, especially the elderly and those with weakened immune systems. Although yeasts and non-dermatophyte molds also play a role in its genesis, dermatophytes like Trichophyton rubrum are the main culprits. Fungal invasion of the nail plate, bed, and matrix causes the infection, which results in nail dystrophy, thickness, and discolouration. Diagnosis remains challenging due to the slow growth of fungi and variable clinical presentations; however, advances such as polymerase chain reaction (PCR), dermoscopy, and reflectance confocal microscopy (RCM) have improved detection accuracy. Current treatment strategies include topical and systemic antifungal agents, combination regimens, and emerging modalities like laser and photodynamic therapy, aimed at enhancing cure rates and reducing relapse. To reduce recurrence, preventive measures including early treatment, footwear, and hygiene are crucial. The pathophysiology, diagnostic techniques, and developing therapeutic approaches in the management of onychomycosis are highlighted in this review, which also emphasizes the necessity of ongoing research to maximize results, overcome treatment resistance, and lower relapse.

Keywords: Diagnosis, Onychomycosis, Pathogenesis, Fungal.