Algorithme de la prise en charge des onychomycoses [Algorithm to facilitate the management of onychomycosis]

An algorithm is proposed to facilitate the management of onychomycosis and ensure a good therapeutical approach. Its aim is to simplify the diagnosis process by integrating a pertinent anamnesis and physical examination with the classic tool of mycology (direct examination, culture, eventually examination by PCR), in order to give the adequate targeted treatment

Diagnostic et traitement des onychomycoses. [Diagnosis and treatment of onychomycosis]

Onychomycosis are the more prevalent nail infections. They may be caused by dermatophytes (Tricophyton rubrum and T. mentagrophytes) as well as by Candida species and a number of other moulds. Laboratory confirmation of a clinical diagnosis of onychomycosis should be obtained before the beginning of oral treatment, because of the long periods of treatment that are usually required, the high costs of such treatments, and the potential side effects of the drugs. However, terbinafine, itraconazole and fluconazole are effective against the dermatophytes in nail. Moulds infections of nails more seldom respond to antifungal therapy

Onychomycosis due to Trichophyton soudanense in Switzerland

We report 2 cases of onychomycosis of the finger- and toenails due to Trichophyton soudanense with a typical clinical picture different from the hyperkeratosis of T. rubrum subungual onychomycosis