Diagnosis and treatment pathway

Podiatry expert Dr Ivan Bristow, University of Southampton, explains the importance of diagnosing, assessing severity and choosing the right way to treat onychomycosis.

Correct diagnosis of onychomycosis, its severity, and assessing patient circumstances* is very important when deciding if and how it should be treated. Leaving the condition untreated poses significant risk as fungal nail infection can contribute to diabetic foot disease10 and is a risk factor in development of lower limb cellulitis11. In the elderly, fungal nail infection can lead to nail deformity and foot pain and this is a risk factor for falls for patients in this age group12.

Dr Bristow explains how the severity of the infection can be determined and what treatments should be considered in each circumstance. Canespro® (40% urea) is effective at dissolving fungal nail leaving non-infected parts intact and plays an important role in the pathway for the treatment of mild-to-moderate infections as explained by Dr Bristow, where results could be seen within 3 weeks9.

Below is a useful pathway showing the steps to identify patients appropriate for treatment for Canespro®.

For more information, click here to download a full length article developed with Dr Bristow.

*Is the infection causing physical discomfort or pain, psychological distress due to its appearance, is it a source for re-infection of the skin, is the patient’s well-being compromised by the infection with particular attention to diabetes and peripheral vascular disease.

If the patient is suitable for treatment, has the suitability of the treatment been considered - some treatments require reaching the toes for self-application and systemic therapies have a greater potential risk for side effects, drug-drug interactions must be considered.

**Antifungal follow-on cream is recommended.

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