Fortnightly Review: Fungal nail disease: a guide to good practice (report of a Working Group of the British Society for Medical Mycology)

<st>Summary points</st> <l type="unord"> Onychomycosis is usually caused by dermatophytes (85-90%), but several fungi that are difficult to treat affect toenails Paronychia is caused by many Candida species, some resistant to azole drugs Samples for mycology should be taken as proximally as possible in the nail Demonstration of hyphae in a nail specimen by microscopy is sufficient to start treatment Choice of treatment depends on many factors including patient's age and preference, infecting fungus, number of nails affected, degree of nail involvement, whether toenails or fingernails are infected, and other drugs being taken </l>