[Differential diagnosis of onychomycosis]

In order to give an effective treatment to a patient with nail disorders, a correct aetiological diagnosis is necessary. Distal and lateral thickening of nail bed and nail plate with onycholysis, deep or superficial leuconychia, melanonychia, paronychia, distal and lateral onycholysis, and total dystrophic onychomycosis are the common physical signs of onychomycosis which represent 50 per cent out of nails disorders. Nail disorders due to cutaneous or general diseases with similar alteration of nail configuration may be confused with onychomycosis. In many cases, an aetiological trend is given by a total body examination of the skin and the mucosa. To diagnose correctly a non fungal nail disorder from an onychomycosis sometimes is a real challenge. According non fungal nail disorder and fungal nail infection may be associated, so a mycological examination and sometimes histopathological examination are very helpful to establish a good diagnosis.