A new classification of onychomycosis

Area of Science:

• Dermatology
• Mycology
• Pathology

Background:

• Onychomycosis, a common fungal nail infection, requires clear classification for effective management.
• Previous classification schemes for onychomycosis have limitations in fully capturing disease presentation.

Purpose of the Study:

• To introduce a novel classification system for onychomycosis.
• To integrate clinical patterns of nail plate involvement with histopathology for a comprehensive classification.

Main Methods:

• Development of a new classification based on distinct clinical patterns of fungal nail infection.
• Inclusion of histopathological findings to support the classification system.
• Identification of five main types: distal and lateral subungual onychomycosis, superficial onychomycosis, proximal subungual onychomycosis, endonyx onychomycosis, and total dystrophic onychomycosis.

Main Results:

• The classification recognizes five primary clinical patterns of onychomycosis.
• It acknowledges that patients can present with combinations of these patterns.
• This detailed classification provides a framework for analyzing disease characteristics.

Conclusions:

• The proposed classification offers a refined understanding of onychomycosis.
• Recognizing specific clinical patterns may correlate with differences in clinical behavior.
• This system has the potential to guide treatment strategies and identify associated conditions.