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Fungal infections may be given different names depending on site, causative organism or clinical presentation.
For each of the twelve cases, study the image(s) and then answer the questions. You can click on the image to view a larger version if required.
Each case should take approximately 2 minutes to complete. There is a list of suggested further reading material at the end of the quiz.
What is this condition called?
Tinea unguium
What is the most likely cause?
Trichophyton rubrum
How would you treat it?
Tinea unguium, or dermatophyte infection of the fingernails and/or toenails, is common and should be confirmed by mycology prior to treatment. Scrape debris from under the nail and send this with distal clippings of the involved part of the nail. It is often difficult to distinguish nail infection from nail dystrophy due to skin disease (e.g. psoriasis), trauma, systemic illness or age-related slowing of nail growth. The irregular discolouration is usually yellow if T. rubrum is the cause and white if T. interdigitale is the cause.
Systemic therapy is much more effective than topical therapy but prolonged courses may be necessary. Treatment in the elderly is often inappropriate and ineffective.