Onychomycosis: clinical and dermoscopic characteristics, diagnosis, and therapeutic management

Onychomycosis is a chronic and recurrent nail infection whose worldwide prevalence continues to increase, affecting 5%-10% of the general population and up to 50% of individuals older than 70 years. Despite the availability of multiple effective therapeutic options, current management practices remain suboptimal, and recurrence rates continue to be high. Recent evidence points to persistent shortcomings in clinical practice, including the underuse of confirmatory diagnostic tests, which entails a greater risk of diagnostic errors, and the frequent initiation of empirical treatment without prior etiological verification, which is associated with treatment failure and resistance, lack of adherence, and persistence of infection. Overall, onychomycosis remains a prevalent and complex clinical problem whose control requires greater diagnostic accuracy, rational use of antifungal agents, and standardized strategies for follow-up and prevention of recurrence.