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Onychomatricoma is a rare benign tumor of the nail matrix, characterized by finger-like projections that invade the nail plate. The fingernails of Caucasian women are most commonly affected. Because this tumor can easily mimic other more prevalent ungual diseases, it is crucial to be acquainted with its characteristic clinical and histopathologic features. The authors present a case of a 40-year-old man with an onychomatrichoma in the fourth left toenail, which was initially misdiagnosed and treated as onychomycosis. [ABSTRACT FROM AUTHOR]

Onychomycosis is usually diagnosed symptomatically due to the very clear signs caused by the fungus on the nail surface and structure, although the growth of the infecting agent must also be verified by culture in an enriched medium. This procedure is normally lengthy (four weeks), and samples can be contaminated, delaying the prescription of appropriate and effective treatment. Only one previous study has addressed the possibility of using thermography as a diagnostic method for onychomycosis in older people (31–70 years). The present study confirms this use but in individuals aged 18–31 years with incipient mycosis and no pathological signs. Using an FLIR E60 BX camera in a study with 214 samples, we found that men had more onychomycosis than women. We observed a relation between the presence of infection and nail temperature, with a higher temperature in yeast infections (+1 °C) and a lower temperature in dermatophyte infections (−2 °C). A higher temperature by almost 1 °C was also observed in older participants. Thermography can be viewed as a new diagnostic method in asymptomatic or incipient onychomycosis, providing the thermographic camera is sufficiently sensitive and the appropriate procedure is followed, although fungal culture is always necessary to confirm recovery after treatment.

This study investigated the human biomonitoring of heavy metals in the water, sediments, and tissues of mostly consumed fish species using Turkmen pregnant women's biomarkers in winter 2019, at the Miankaleh Peninsula, north of Iran. Metal concentrations were measured in various fish organs as well as pregnant women's blood, hair, and nail as biological indicators. For this purpose, a total of 20 water and sediment, 14 fish, and 16 human samples were collected. Inductively coupled plasma mass spectrometry (ICP-MS) was used to evaluate the concentration of Cr, Co, Cu, As, Hg, and Pb. Results showed metals with the highest concentrations as Cu and Cr in water (93.35 and 80.91 µg/l, respectively), Hg and Pb in sediment (7.40 µg/g for both), Cu and Pb in the liver (27.00 and 18.9 µg/g for C. carpio; 1414 and 31.7 µg/g for L. auratus), muscle (10.00 and 18.80 for C. carpio; 37.20 and 8.27 µg/g for L. auratus), and skin (26.40 and 9.90 for C. carpio; 10.80 and 11.74 µg/g for L. auratus). In addition, Cu, in pregnant women samples, had the highest values at 2.53 mg/l, 8.87, 36.46, and 29.04 µg/g for blood, hair, fingernail, and toenail, respectively. However, Co showed the lowest concentration in all studied samples. Fish liver and fingernail of pregnant women did reveal the highest heavy metal accumulation, whereas fish muscle and blood of pregnant women had the lowest accumulated heavy metals. The concentration of Hg in water, sediment, fish muscle, and women's blood and hair exceeded the limits suggested by various organizations. Therefore, this study highlighted that heavy metal concentration, in particular Hg, in water, sediments, and fish is a serious risk to the health of local inhabitants who rely on fisheries products and recommended that necessary information should be provided to warn Turkmen pregnant women in consumption of Hg-contaminated fish in this area. [ABSTRACT FROM AUTHOR]

A robust segmentation method that can be used to perform measurements on toenails is presented. The proposed method is used as the first step in a clinical trial to objectively quantify the incidence of a particular pathology. For such an assessment, it is necessary to distinguish a nail, which locally appears to be similar to the skin. Many algorithms have been used, each of which leverages different aspects of toenail appearance. We used the Hough transform to locate the tip of the toe and estimate the nail location and size. Subsequently, we classified the super-pixels of the image based on their geometric and photometric information. Thereafter, the watershed transform delineated the border of the nail. The method was validated using a 348-image medical dataset, achieving an accuracy of 0.993 and an F-measure of 0.925. The proposed method is considerably robust across samples, with respect to factors such as nail shape, skin pigmentation, illumination conditions, and appearance of large regions affected by a medical condition. [ABSTRACT FROM AUTHOR]

Objectives: Existing surgical and conservative treatment techniques applied to ingrown toenails remain controversial. In this study, a new minimally invasive technique for the treatment of ingrown toenails is described which was found to provide rapid healing and effective results. Methods: The presented study includes 39 patients with ingrown toenails treated with the newly developed technique. The technique is a minimally invasive procedure in which a half groove-shaped piece obtained from the intravenous drip set plastic was placed between nail and dermis and fixed on the nail. Results: The patients treated with this technique were followed up after one week, one month and six months. According to six-month follow-up results of the patients, achievement rate of the presented technique was found to be quite high at 80%. Conclusions: This new technique has many advantages compared to existing ingrown toenail treatment methods. It was revealed that this method is very effective and successful by not requiring dressing, ensuring low pain, rapid recovery from the first day of the treatment, uninterrupted return to daily life, and low recurrence rate. One of the most important advantages of the technique is that it ensures high patient satisfaction by providing good functional and aesthetic results. [ABSTRACT FROM AUTHOR]

Background: Various nail manifestations have been reported with COVID‑19; mostly in the form of isolated reports. Objective: This cross‑sectional study was carried out to assess nail changes in hospitalized patients with moderate to severe COVID‑19. Methods: Nail findings in 43 adults being treated for COVID‑19, were evaluated after obtaining informed written consent. Nail changes involving fingernails and toenails were documented as new‑onset or pre‑existing changes. Disease status, hematological and biochemical tests, inflammatory markers, treatment administered and outcomes were also recorded. The frequency of changes in fingernails and toenails were statistically compared. Results: The red half‑moon sign (32.5%) and nail bed erythema (34.8%) were the commonest changes seen in fingernails; while apparent leukonychia (46.5%) and distal brown discoloration (51.1%) were commonest changes in toenails. The difference in frequency of changes seen between fingernails and toenails was statistically significant (p < 0.05). Nail changes correlated with systemic involvement in these patients. Limitations: Single‑center evaluation in a limited number of patients, without using augmented examination techniques like onychoscopy, nail fold capillaroscopy, or fluoroscence. Those with less severe disease or with rapid fatality could not be studied. Conclusion: Nail changes in COVID‑19 are common and reflect the systemic nature of illness, being a harbinger of underlying complications. [ABSTRACT FROM AUTHOR]

Elemental homeostasis is essential for maintaining normal metabolic processes. Elements in the toenails are now considered in the diagnosis or screening and used as biomarkers of several metabolic disorders. The incidence of obesity is more prevalent in females than males globally. At the same time, females appeared more susceptible to elemental alterations than males. This study aimed to evaluate the variation in the levels of several elements in toenails as possible biomarkers of health conditions associated with obesity in young Saudi females. A cross-sectional study was performed, between February-November 2019. The study enrolled 79 young females divided into two groups: participants with obesity (n=39) and non-obese (n=40). The toenail was analyzed to estimate Fe, I, K, Na, Cd, Cr, Mn, Ca, Mg, Cu, Co, and Se levels. The study showed a significant elevation in the levels of Fe, Ca, K, and Na in the toenail sample of female participants with obesity compared to the non-obese group. The levels of Mn, Cd, Co, Cu, and Cr, were significantly decreased in the toenail of participants with obesity. Moreover, other elements (i.e., Mg, I, and Se) were not significantly lower in the female group with obesity. Our findings confirmed the alterations of several elements among Saudi females with obesity. The toenail elemental analysis may become a useful diagnostic technique in monitoring the nutritional status, predicting some metabolic disorders, and environmental exposure. [ABSTRACT FROM AUTHOR]

Background: Split nail (SN) is a rare type of nail fragility syndrome, characterized by a longitudinal fissure involving the entire thickness of the nail plate. Longitudinal nail splitting may be caused by direct injury to the nail plate or matrix insult. Few articles have been published on the topic, most were related to the traumatic aetiology. Some case reports mention tumours and inflammatory disorders as other causes. Objectives and Methods: The aim of this retrospective study was to analyse the clinical and histopathological features of 56 SN collected at the nail consultation of the dermatology department at Saint Pierre University Hospital in Brussels, between 1997 and 2019. Results: Fifty‐six patients were included (34 women and 22 men) with median age of 44.2 years. The fingernails were 3.2 times more frequently affected than toenails, especially the thumb. The most frequent aetiologies were tumours (45.6%), inflammatory diseases (26.3%) and traumas (19.3%). Congenital (5.3%) and systemic disorders (3.5%) were rarer causes. Histopathological slide review confirmed that alteration of the nail matrix integrity causes split nail, resulting either from matrix stretching by an underlying tumour or from impairment of the keratinization process by inflammatory diseases, melanocytic tumours and Bowen's disease. Conclusions: This study is the largest case series of longitudinal nail splitting to date. It is the first to gather nail disorders causing SN with their clinical pathological correlation. The most common causes are traumatisms, tumours and inflammatory disorders. Congenital and systemic disorders are rarer. Tumours are responsible for half of the cases from which one third are malignant, mainly melanoma. When facing a monodactylic SN, benign as well as malignant tumours should be ruled out before concluding to traumatic aetiology. [ABSTRACT FROM AUTHOR]

Local antibiotic therapy is increasingly being recognised for its role in preventing and treating orthopaedic device-related infection (ODRI). A bioresorbable, injectable gentamicin-loaded hydrogel has been developed to deliver local antibiotics at the time of surgery with potential for both prevention and treatment of ODRI. In a prophylaxis model, the antibiotic hydrogel was compared with systemic perioperative antibiotic prophylaxis alone in twelve sheep (six per group) at the time of intramedullary (IM) nail insertion to the tibia, which was inoculated with methicillin-sensitive Staphylococcus aureus (MSSA). In a treatment model of single-stage revision surgery, adjunctive antibiotic-loaded hydrogel was compared with systemic antibiotics alone in a single stage revision of MSSA infection associated with a tibia intramedullary nail in eleven sheep (five/six per group). The primary endpoint was quantitative microbiological results of soft tissue, bone and sonicate fluid from explanted hardware at the time of euthanasia. At euthanasia, the control sheep that received no local antibiotics in the prophylaxis model were all culture-positive (median 1x108, range 7x106-3x108 colony forming units, CFU) while only two of six sheep receiving local gentamicin had any culture positive biopsies (median 1x101, range 0 - 1x105 CFU). For the treatment model, sheep receiving only systemic antibiotics were all culture-positive (median 8x105, range 2x103- 9x106 CFU) while only two of six sheep treated with gentamicin-loaded hydrogel had any culture positive biopsies (median 3x102, range 0 - 7x104 CFU). Local gentamicin concentrations measured in extracellular fluid in the tibial canal show a burst release of gentamicin from the hydrogel. Serum gentamicin concentrations peaked in both models at one day post application and were below detection limit thereafter. This study has demonstrated the effective use of a locally delivered antibiotic hydrogel for both the prevention and treatment of ODRI that is superior to that of systemic antibiotics alone. Future studies will endeavour to translate from preclinical to clinical research trials. [ABSTRACT FROM AUTHOR]

Background: Previous studies reported that cellular remnants in the nail plate could be a diagnostic clue for subungual melanoma (SUM). We sought to characterize the histopathologic features of cellular remnants in the nail plates of SUM patients. Methods: A retrospective case‐control study was conducted in a single tertiary center from 2012 to 2019. Twenty‐three patients with pathologically diagnosed SUM and eight nail matrix nevi (NMN) patients were recruited. The analysis of the nail plate specimens focused on large cellular remnants of melanocytes (LCRMs). Longitudinal linear density and vertical distribution pattern of the LCRMs were scrutinized for possible features distinguishing SUM from NMN. Results: The median linear density of the LCRMs was significantly higher in the SUM samples than in the NMN samples. LCRMs in the SUM samples were more dorsally distributed than those in the NMN samples. In invasive SUM, LCRMs were more likely to be found in the dorsal part of the nail plate compared to SUM in situ. Conclusion: Nail plate specimens should not be overlooked in the histopathological examination of melanonychia. High‐density LCRMs with more dispersion to the dorsal side might be suggestive of SUM. [ABSTRACT FROM AUTHOR]

We conducted a critical review on biomarkers of environmental manganese (Mn) exposure to answer the following questions: 1) are there reliable biomarkers of internal Mn exposure (Mn in biological matrices) associated with external metrics of Mn exposure (Mn in environmental media)? and 2) are there accurate reference values (RVs) for Mn in biological matrices? Three bibliographic databases were searched for relevant references and identified references were screened by two independent reviewers. Of the 6342 unique references identified, 86 articles were retained for data abstraction. Our analysis of currently available evidence suggests that Mn levels in blood and urine are not useful biomarkers of Mn exposure in non-occupational settings. The strength of the association between Mn in environmental media and saliva was variable. Findings regarding the utility of hair Mn as a biomarker of environmental Mn exposure are inconsistent. Measurements of Mn in teeth are technically challenging and findings on Mn in tooth components are scarce. In non-occupationally exposed individuals, bone Mn measurements using in vivo neutron activation analysis (IVNAA) are associated with large uncertainties. Findings suggest that Mn in nails may reflect Mn in environmental media and discriminate between groups of individuals exposed to different environmental Mn levels, although more research is needed. Currently, there is no strong evidence for any biological matrix as a valid biomarker of Mn exposure in non-occupational settings. Because of methodological limitations in studies aimed at derivation of RVs for Mn in biological materials, accurate RVs are scarce. [ABSTRACT FROM AUTHOR]

Background: A few studies discussed the factors correlated to response in laser treatment of onychomycosis. Objective: This study aimed to seek big toenail onychomycosis features that correlate with response to 1064 nm Nd: YAG laser treatment. Methods: This single‐center, retrospective study included patients who had only one big toenail onychomycosis, with a confirmed mycological diagnosis and/or a high clinical suspicion. Patients had three sessions 1 month apart. The following characteristics were collected from the patients' files: age, sex, smoking and arterial hypertension statuses, results of baseline mycological culture, Onychomycosis Severity Index (OSI) score at baseline and at the end of the 6‐month follow‐up, as well as the reported side effects. Results: We included 105 patients, 86 women and 19 men, with a mean age of 43 years. Demographics have shown that 73.6% of patients were smokers, 17.9% had arterial hypertension, 61.9% had a culture positive for Trichophyton species, and 9.4% had a culture positive for Candida species. According to the OSI score, onychomycosis was mild in 18.9%, moderate in 39.6%, and severe in 41.5% of patients. At 6 months, clinical cure was achieved in 57.1% of patients. Conclusion: The OSI decrease after 3 sessions of Nd: YAG laser was significantly more important in women and in patients with positive mycology culture, smaller affected area of the nail, no subungual hyperkeratosis, and no nail matrix involvement. Age, smoking, hypertension, and side effects were not shown to significantly correlate with the decrease of the OSI score. [ABSTRACT FROM AUTHOR]

Background: Onychocryptosis, also known as ingrown toenails or ungues incarnati, is a fairly frequent condition, with global prevalence of approximately 20%. Objectives: This study is aimed at discussing possible conservative management of severe onychocryptosis, with a case report. Methods: Conservative approach is effective in reducing or even entirely correcting underlying nail deformities. Eliminating nail fold inflammation is necessary prior to the bracing procedure. The non‐surgical approach combined with proper wound treatment of the involved nail folds is a promising alternative for a growing number of patients. Results: Nail plate deformities may be largely corrected or fully eliminated. As demonstrated by our case report, even advanced stages of onychocryptosis may be effectively treated with nonsurgical modalities. Conclusion: Proper podiatric care facilitates conservative approach to management of ingrown toenails, improving the patient's overall wellbeing and eliminating pain. The prerequisite for nonsurgical correction of the nail plate is treating inflammation first. Conservative correction is more aesthetically pleasing and less emotionally disturbing to the patients than partial or complete surgical avulsion. Lesser invasiveness is an advantage especially in the case of patients with chronic comorbidities. [ABSTRACT FROM AUTHOR]

Background: Toenail onychomycosis is a frequent fungal infection that is difficult to treat, especially in elderly patients. Diverse local and systemic antifungal treatments are available with variable results. Recently, different laser systems have been proposed for the treatment of onychomycosis, among them a class IV laser system adopting three different wavelengths, that is, 650, 810, and 915 nm (K‐Laser Cube 3TM). Objectives: This prospective pilot study aims to clarify the clinical, histopathologic, and cultural mycological efficacy of the combination of a triple wavelength laser system and local mechanical abrasion in the treatment of toenail onychomycosis. Methods: Eight treatment sessions were performed involving a mechanical drill of the friable nail material followed by the laser treatment with four 2‐minute cycles per nail with a median power of 3 W providing 240 J each. Clinical exam, mycological culture, and histopathology with PAS staining of nail clips were performed at the beginning and the end of the treatment period. Results: Nine patients with 16 clinically involved nails were included in this study (median age: 55.6). Clinical improvement was noted in eight patients (89%) at the end of the treatment cycles. Initial positive cultures could be reduced from six (67%) to two (22%), P = 0.07, while histopathologic examination by PAS staining remained invariable positive in all patients (100%). Conclusion: Despite clinical improvement, the combination of this laser treatment and mechanical abrasion could not reduce the fungal infection rate in affected toenails. Additional local or systemic antimycotic agents should be combined in order to avoid expected clinical recurrences. [ABSTRACT FROM AUTHOR]

Long-term exposure to environmental arsenic has been associated with many chronic diseases, including several cancers, and diabetes. Urinary studies have implicated arsenic speciation as an important risk factor, however, such associations have not been replicated using toenail samples: a relatively new biosample for estimating long-term internal dose-exposure to arsenic. Despite having several advantages over conventional biosamples such as ease of collection and storage, standard methods for arsenic speciation analysis in toenails have not yet been established. The primary objectives of this study were to 1) establish an analytical method for arsenic speciation analysis in toenails, 2) describe preliminary arsenic speciation profiles of toenail samples from individuals with skin, lung, bladder, and kidney cancer, type II diabetes, and no known disease, and 3) determine if these speciation patterns differ between disease groups to inform the feasibility of subsequent research. A small cross-sectional feasibility study was carried out using 60 toenail samples and baseline questionnaire data from the Atlantic Partnership for Tomorrow’s Health (Atlantic PATH) study. Arsenic speciation profiles were determined using high performance liquid chromatography (HPLC) paired with inductively coupled plasma-mass spectrometry (ICP-MS). While no differences in total arsenic were found, arsenic speciation profiles were significantly different between certain cancer groups and the reference group with no known disease. Specifically, the percentage of monomethylarsonic acid (%MMA) was found to be significantly higher in the toenails of individuals with lung cancer and kidney cancer, compared to healthy individuals with similar total arsenic exposure. To the best of our knowledge, this is the first study to describe arsenic speciation patterns in individuals with several arsenic-related diseases using toenails: a convenient, non-invasive, biobankable sample capable of longer-term exposure estimation than conventional biosamples. These preliminary data provide evidence that toenail arsenic speciation patterns differ between groups with arsenic-related disease, and those with no known disease. Toenail arsenic speciation analysis is feasible and could potentially have important implications for research on arsenic-related diseases. Further investigation is warranted and would benefit from including detailed arsenic exposure data to explore the observed heterogeneity in arsenic speciation profiles.

This article discusses a case study on the treatment of onychogryphosis, a nail deformity characterized by thickened and curved nails. The exact cause of onychogryphosis is not well understood, but it can be triggered by trauma, fungal infections, and other factors. Currently, there is no curative treatment for onychogryphosis, and the recurrence rate is high. However, this case study reports the successful use of intramatrix dexpanthenol injection in the treatment of onychogryphosis, resulting in significant clinical improvement without any observed side effects. Further research is needed to understand the exact pathogenesis of onychogryphosis and confirm the effectiveness of this treatment. [Extracted from the article]

Objective: To study the efficacy of Infrared light therapy in treating Onychomycosis. Study Design: Cross-sectional study. Place and Duration of Study: Department of Dermatology, Combined Military Hospital, Bahawalpur Pakistan, from Jan to Jul 2022. Methodology: A total of 122 patients of either gender with Onychomycosis were included in the study. Sessions with infrared light (24W Red Bulb, 660nm-850nm wavelength) were arranged once a week. The total duration of therapy consisted of four weeks in the case of fingernails and eight weeks in the case of toenails. Patients were called for follow-up at the end of the first, second, and third months after completion of treatment for efficacy evaluation. Results: The mean duration of complaints was 9.12±2.58 weeks, and the mean weight of patients was 84.11±8.38Kg. Male patients were 36(29.5%), and females were 86(70.5%). 98(80.3%) patients had toenail involvement, and 24(19.7%) patients had fingernail involvement. Efficacy was defined as 2/3rd (66.0%) clearance of the nail plate after 90 days of completion of treatment from the first observation at the time of presentation on visual examination. Efficacy in our study was observed in 25(20.5%) patients. Conclusion: Our study concluded that infrared light therapy is an effective treatment modality for Onychomycosis. [ABSTRACT FROM AUTHOR]

Otherwise, there was no difference in treatments or clinical outcomes between fingernail-only and fingernail/toenail patients. Fingernail/toenail vs. fingernail-only patients more often had tinea pedis history (20% vs. 6% respectively; I p i = 0.048), with no difference in number of fingernails or hands involved (Table 1). Fingernail involvement comprises up to 6% of onychomycosis cases, but has greater quality-of-life impact compared to toenail onychomycosis.[[1], [3]] Since fingernail onychomycosis has not been well studied, our objectives were to retrospectively examine demographics, clinical features, treatments and pathogens in patients with fingernail onychomycosis. [Extracted from the article]

Device-based therapies have been used for onychomycosis patients with intolerance to systemic treatments. Photodynamic therapy (PDT) improves onychomycosis, while fractional carbon dioxide (FrCO2) augments the topical drug delivery. Comparative studies between PDT alone and laser-assisted one are lacking. We aimed to evaluate the efficacy of PDT alone versus FrCO2-assisted PDT for treatment of onychomycosis. Twenty-one patients with bilateral onychomycosis of toenails with nearly the same degree of affection were enrolled in this prospective intra-patient-controlled study. The right affected toenail was treated via PDT alone. The left toenail was treated via a FrCO2 followed immediately by PDT. The sessions were bimonthly for a total of six sessions. Direct microscopy, fungal cultures, clinical evaluation, onychomycosis severity index scoring, and patient's satisfaction were assessed before and 12 weeks after the last session. Both treatments reduced significantly the onychomycosis severity index (p <.05) without significant difference between them. The improvement in nail appearance and patient's satisfaction were higher in laser-assisted PDT than PDT alone (p <.05). Both treatments effectively reduced the severity of onychomycosis with a high degree of safety and tolerability. Fractional CO2-assisted PDT enhanced the clinical outcome via improving the nail appearance and patient's satisfaction. Photodynamic therapy has a good success rate in clearing onychomycosis. Addition of fractional CO2 to photodynamic therapy improves the nail appearance and induces better satisfaction to treatment. [ABSTRACT FROM AUTHOR]

Toenail fungal infections account for half of all nail disease cases, and a highly negative impact on patient quality of life. Our aim was to compare the efficacy and safety of commercially available oral antifungals for onychomycosis. A systematic review was performed in PubMed and Scopus. Randomized controlled trials evaluating the effect of oral antifungals on mycological cure, discontinuation and adverse events were included. Network meta-analyses were built for each outcome. Results were reported as odds ratios (OR) with 95% credibility intervals (CrI). Ranking probabilities were calculated by surface under the cumulative ranking analysis (SUCRA). We included 40 trials (n = 9568). Albaconazole 400 mg (OR 0.02 [95% CrI 0.01–0.07] versus placebo), followed by posaconazole 200–400 mg and terbinafine 250–350 mg were considered the best therapies (SUCRA probabilities over 75%). For the networks of discontinuation and individual adverse events, few significant differences among treatments were observed, but itraconazole 400 mg was considered the safest drug (SUCRA around 25%). Albaconazole 400 mg, posaconazole 200–400 mg, and terbinafine 250–350 mg were the most effective therapies for onychomycosis, while itraconazole 400 mg was the safest. The profile of albaconazole and posaconazole compared to current first-line therapies should be further investigated in well-designed trials. [ABSTRACT FROM AUTHOR]

Objective. To investigate the different efficacy of proximal femoral nail antirotation (PFNA) combined with or without a microexternal fixator in the treatment of coral-plane femoral intertrochanteric fractures. Methods. 120 patients with intertrochanteric coronal fractures who received treatment in four hospitals from February 2020 to February 2021 were retrospectively included in this study. They were divided into control (PFNA alone, n = 60) and combined treatment group (a microexternal fixator + PFNA, n = 60) according to different surgery methods. All patients were followed up for 6 months. Operative time, amount of intraoperative blood loss, postoperative length of hospital stays, fracture healing time, Harris hip score, modified Barthel index, hip function excellent and good rate, and incidence of complications were compared between the two groups. Results. There were no significant differences in operative time, amount of intraoperative blood loss, postoperative length of hospital stay, and incidence of complications between the two groups (all P > 0.05). Fracture healing time in the combined treatment group was significantly shorter than that in the control group (P < 0.05). After surgery, Harris hip score and modified Barthel index in each group were significantly increased compared with before surgery (both P < 0.05). The increases in Harris hip score and modified Barthel index in the combined treatment group were significantly greater than those in the control group (both P < 0.05). After surgery, Harris hip function excellent and good rate in the combined treatment group was significantly higher than that in the control group (83.33% > 66.67%, P < 0.05). Conclusion. Compared with PFNA alone, a microexternal fixator combined with PFNA for the treatment of coronal plane femoral intertrochanteric fractures can greatly shorten fracture healing time and improve postoperative hip function and activities of living ability, but it cannot greatly increase operative time, the amount of intraoperative blood loss, or the risk of postoperative complications. [ABSTRACT FROM AUTHOR]

Background: This study aimed to report the outcomes of mimical reconstruction and aesthetic repair of the nail.Methods: When the pigmented bands were more than 1/2 the width of the whole nail, mimical reconstruction of the nail was performed, with a lateral toe pulp island flap covering the wound via the subcutaneous channel. If the pigmented bands were 1/4 to 2/5 the width of the entire nail, aesthetic repair of the nail was carried out by split-thickness excision under a microscope.Results: The average age of patients at the time of surgery was 14.5 years. Five patients had lesions on their toes, while three had lesions on their fingers. There were no post-operative complications. All toenails of the five patients who had undergone mimical reconstruction exhibited a well-settled flap. The nails of the three patients who underwent aesthetic repair displayed no nail malnutrition or deformity, and all nails had an aesthetic appearance.Conclusions: Both mimical reconstruction and aesthetic repair of the nail following resection of subungual melanocytic nevus are reliable and feasible. The "like tissue" repairs of complex nail defects appear to be satisfactory. All patients had excellent aesthetic outcomes.Level Of Evidence: V. [ABSTRACT FROM AUTHOR]

The commensal microbiome influences skin immunity, but its function in toenail health remains unclear. Paronychia is one of the most common inflammatory toenail diseases, but antibiotic treatment is seldom effective in clinical cases. In this study, we performed 16S rRNA sequencing to investigate the characteristics of microbes associated with paronychia in order to identify the key microorganisms involved in inflammation. Seventy dermic samples were collected from patients with paronychia and the differences in dermic microbiota were analyzed in patients with different inflammation severities. Distinct clustering of dermal microbiota was observed in the dermis with different inflammation severities. A higher relative abundance of anaerobic microorganisms such as Parvimona , Prevotella , and Peptoniphilus was observed in severe paronychia, whereas Lactobacillus disappeared with disease progression. Co-occurring network analysis suggested that the disturbance of the dermic microbiome and attenuation of antagonism by Lactobacillus against anaerobic pathogens may aggravate inflammation in paronychia. Functional analysis showed that dermic microbiome disturbance may worsen microbial metabolism and tissue repair in the skin. In conclusion, we revealed that an increased abundance of anaerobic microorganisms and loss of Lactobacillus in the dermis may promote paronychia progression and microbiological imbalance may aggravate inflammation in patients with paronychia. [ABSTRACT FROM AUTHOR]

Summary: Background: Onychoscopy is a technique that uses a dermatoscope for the evaluation of specific features of different skin conditions that are not visible to the naked eye. There are few studies establishing parameters for the diagnosis of onychomycosis based on onychoscopy. Determining the sensitivity and specificity of a potentially new diagnostic test for onychomycosis requires an evaluation study of this new diagnostic test, as there are limited studies reporting onychoscopy results. Aim: To determine the sensitivity, specificity, positive predictive value and negative predictive value of onychoscopy findings in a Colombian population with onychomycosis. Methods: We assessed outpatients with a diagnosis of toenail onychomycosis confirmed by potassium hydroxide preparation or fungal culture. Onychoscopy was performed using a dermatoscope, and digital images collected using a smartphone. Results: The onychoscopy findings were: longitudinal striae, distal spiked pattern, distal irregular termination, linear edge and ruins aspect, while some patients were confirmed as having traumatic onycholysis. A statistically significant association was found between the clinical symptoms of onychomycosis and both the clinical feature of dyschromia and the onychoscopy feature of longitudinal striae. Conclusion: We suggest that this technique is an alternative method that should be used in patients with onychopathies because it has the potential to differentiate onychomycosis from traumatic onycholysis and another nail involvement. [ABSTRACT FROM AUTHOR]

Elephant is Thailand's national animal which represents three aspects: loyalty, longevity, and strength. Thai elephants are often used for deforestation and tourist activities, such as elephants, riding, and showering. This case report highlights a traumatic wound in the left foreleg nail of a showering Thai elephant. Nail wounds undergo infection and tissue necrosis. A bone fragment suspected to be part of the distal phalanges was found and confirmed by X-ray examination. However, a surgical approach is not recommended because of the high risk of sedation in elephants. Routine wound cleaning with antiseptics and topical antibiotics was performed on the traumatic wounds. The bone fragment was removed after necrosis of the surrounding tissues. The prognosis for this case was considered good based on the location and wound condition. [ABSTRACT FROM AUTHOR]

All patients with breast cancer, older than 18 years, who underwent antineoplastic treatment were included in the study; patients receiving antifungal treatment were excluded. Since moulds are opportunistic fungi, the loss integrity of the nail and slowing of nail growth associated with antineoplastic therapies favor superinfection and could explain, at least in part, this high prevalence. In Europe, the number of new cases is 522,091 (25.2%) and in Spain, it is 32,536 (16%).1 Breast cancer therapy includes the use of various antineoplastic agents that cause nail alteration which increases the risk for onychomycosis. [Extracted from the article]

Objectives: Social distancing practices brought on by the COVID-19 pandemic have limited the ability of residency training programs to deliver procedure training via traditional in-person methods. Financial strains brought on by the pandemic also mean that fewer resources may be available to develop novel teaching processes. We sought to investigate a protocol meant to address the rising need for inexpensive procedure training that can be performed remotely or in a socially distanced manner. Methods: We used a sausage model to train 11 family medicine residents in toenail procedures. The training was delivered via two-way video telecommunication as the residents were separated into small groups in separate rooms. Learners were given a cognitive skills evaluation and were asked to perform a self-assessment of their confidence with procedures using a scale of 1–10. These assessments were administered before and after the procedure and the results were compared using a paired t-test. Results: The cognitive score improved from a pretest average of 73.6% to a posttest average of 86.0% (P = 0.022). The improvements in trainee self-assessment were significant for all performance characteristics of the procedure. Conclusions: This evidence supports the use of synchronous video communication to train family medicine residents in toenail procedures using a sausage model. [ABSTRACT FROM AUTHOR]

Nails have both functional and aesthetic importance. Undertreatments cause frequent recurrences affecting its functionality, while over-treatment spoils the aesthetic view. To describe the most practical and aesthetic method to treat ingrown toenail. All patients with ingrown toenail who applied to outpatient clinics of General Surgery Department between 2013 and 2019 were enrolled. A 2-mm space between tissue and nail by lateral longitudinal excision was created with only minimal matricectomy, under local anaesthesia. A total of 2334 surgical procedures were performed in 2118 patients. Recurrence rate was 1.7% during 36-month follow-up, most (70.7%) in younger men (22 years). The location of the lesions (right/left, medial/lateral or bilateral) did not show difference (p > 0.05 for each). Predisposing factors were tight-fitting footwear (4.5%), incorrect nail-trimming (3%), genetic tendency (2.8%), obesity (2.1%) and trauma (0.75%); but each was p > 0.05. Mean operation time was 3 min. There was no important complication, except hematoma (0.89%) and infection (0.68%). Mean healing time was 10 days and patients returned to daily activities in 3 days. Longitudinal excision with minimal matricectomy technique provides all dead tissue and diseased parts of nail and soft tissue to be removed. It is simple, cost-effective, satisfactory and aesthetic. SBU/23.01.2019/B.10.1.TKH.4.34.H.GP.0.01/7 (retrospectively registered). [ABSTRACT FROM AUTHOR]

Background: The analysis of nail surface topography is a subject of ever‐increasing interest in dermatology, especially in cosmetic studies. However, there is no accurate and scientifically sound instrumental method that can identify and provide quantitative data on nail surface topography. Materials and Methods: The right index fingers of 78 healthy individuals were examined. The severity of nail roughness was rated by two independent dermatologists on a scale of 1 to 3. Using the phaseshift rapid in vivo measurement of the skin (PRIMOS) system, three‐dimensional microtopography was performed, and the roughness parameter values were calculated and evaluated. The relationship between clinical nail roughness grade and nail roughness parameter values obtained utilizing PRIMOS was evaluated. Results: A moderate correlation was found between the roughness parameter values and the clinical roughness grade. Our study showed that an overall relationship exists between the nail roughness parameter values obtained using PRIMOS and clinically observed nail surface changes. Conclusion: With further studies, PRIMOS could be a valuable tool for clinicians and researchers for conducting an accurate and objective patient assessment in daily practice and demonstrating effectiveness of different therapies for nail dystrophy or evaluating cosmetic effects of various topical treatments in future clinical trials. [ABSTRACT FROM AUTHOR]

A 57-year-old male patient with > 10-year history of type 2 diabetes presented with a left big toenail deformity and pain. A physical examination revealed a white and yellow-to-brown patch on the nail as well as thickening and ingrowth of the nail plate. The nail plate was opened using nippers, and a fungal culture revealed Trichophyton interdigitale with yellow yeast. The yeast isolate was identified as Kocuria koreensis, a Gram-positive aerobic coccoid with keratinolytic properties that is part of the normal flora of the skin. We created an ex vivo onychomycosis model of T. interdigitale infection of the human nail by placing a sterilized normal nail on the cultured slant. K. koreensis initially spread over the normal nail, and T. interdigitale then penetrated the nail plate. After one year and sixmonths, a spiral ingrown nail developed. A histopathological examination of the spiral revealed onychomycosis with superficial and deep abscesses of Gram-positive cocci infection. We performed PCR from paraffin-embedded material, and the sequences obtained were identical to those of T. interdigitale and K. koreensis. These results suggest that the development of onychomycosis by T. interdigitale is introduced and accelerated by K. koreensis, and the symbiosis of these microorganisms is suspected in the nail. This ex vivo model has a number of limitations. Therefore, further research on co-infected cases is needed to confirm this hypothesis. [ABSTRACT FROM AUTHOR]

Successful management of onychomycosis is a challenge because cure rates with most antifungals are relatively low and recurrence rates are high. A drug‐based approach by treating the nail alone may not suffice. There are several host‐related factors (age, sex, body mass index [BMI], and patient's quality of life), disease‐related factors (disease severity, duration, and the number of toenails affected), and comorbidities (tinea pedis and diabetes) that may affect treatment efficacy. Here, we review the post hoc analyses of the phase III trials of efinaconazole 10% solution that have investigated the impact of these factors on topical therapy for toenail onychomycosis. The significant clinical variables that may affect the efficacy of efinaconazole include sex, BMI, disease severity, disease duration, and tinea pedis. As older patients may have slower toenail growth and more severe, longstanding disease compared with younger patients, they may require longer treatment duration, beyond the 48‐week standard regimen. Treatment compliance may need to be discussed for an improved health outcome. Therefore, these prognostic factors need to be carefully evaluated, which may aid in formulating individualized therapy to maximize treatment success. [ABSTRACT FROM AUTHOR]

Onychomycosis is one of the most common foot conditions. Mixed onychomycosis and onychomycosis caused by non-dermatophyte moulds are increasing in incidence, especially in vulnerable populations, hence the importance of this study, which presents the prevalence of onychomycosis in a population of homeless people, comparing the findings with a sample of a well-resourced population. The total sample consisted of 70 participants, divided into two separate groups, a homeless population and a second group in which we included people attending a private clinic. The average age of the sample is [49.19 ± 28.81] with an age range of 18 to 78 years. In the homeless group, the most prevalent infectious agents were non-dermatophyte fungi, with a total of 48%, compared to 28% in the group housed. The most common site of infection in both groups was the nail of the first finger. We, therefore, conclude that there is a difference in the infecting agent in the homeless population and the population with homes.

The objective of this publication is to present the interest of collecting several keratinous specimens in order to document possible drug impairment at the time of the assault, when knowledge solely occurred 7 months after. A subject committed a murder and within minutes after the crime self-inflicted serious wounds. He was charged to the hospital where he slowly recovered. After several weeks, he was sent to prison. During this period, intelligence indicated possible drug impairment at the time of the assault after using 25I-NBOMe and 4-MMC. Head hair (4 cm), axillary hair, and toenails were collected 7 months after the crime. New psychoactive substances were tested in each specimen using LC-MS/MS, which revealed the presence of 25I-NBOMe and 4-MMC in axillary hair (2 and 6 pg/mg) and toenails (1 and 5 pg/mg). However, the perpetrator claimed that the positive findings were due to contamination in prison. Therefore, the head hair was also tested and results returned negative (LOQ at 1 pg/mg), demonstrating absence of contamination during the last 4 months before collection. Combining the window of drug detection in axillary hair (about 4 to 8 months) and the one of toenail clippings (up to 8 months), and excluding drug exposure during the previous 4 months as well as external contamination as the head hair results were negative, allowed us to conclude that the positive findings in axillary hair and toenails are more likely than not consistent with consumption of both 25I-NBOMe and 4-MMC at the time of the crime. [ABSTRACT FROM AUTHOR]

To monitor deficient or excessive intakes of biologically available fluoride (F), various biological samples have been tested for use as biomarkers of human exposure to F. Most such studies have concerned children and often have only involved measurement of F in 1 or 2 types of sample. The present study investigated the relationships of F concentrations in biomarkers of F exposure; including plasma, saliva, hair, finger- and toenails, and daily urinary F excretion (UFE) with the total daily F intake (TDFI) of adults. TDFI was assessed in 60 healthy adults, aged ≥20 years; 31 lived in a low-F water area (LFA, 0.04 mg F/L) and 29 in a high-F water area (HFA, 3.05 mg F/L) of Nigeria. All volunteers provided at least 1 biomarker sample from the above list and completed a questionnaire to evaluate F intake from the diet and toothpaste ingestion. TDFI, UFE and F concentrations of biomarkers were statistically significantly higher in the HFA than in the LFA. There were strong statistically significant positive correlations between TDFI and UFE (ρ = 0.730, p < 0.001); plasma F (ρ = 0.729, p < 0.001); fasting whole saliva F (ρ = 0.653, p < 0.001) and hair F (ρ = 0.603, p < 0.001). The statistically significant positive correlations between TDFI and fingernail F (ρ = 0.502, p < 0.001) and between TDFI and toenail F (ρ = 0.556, p < 0.001) were moderate. In conclusion, this study has indicated the usefulness of 24-h UFE as well as F concentration in plasma, fasting whole saliva and hair as biomarkers of contemporary or sub-chronic F exposure in groups of adults. However, they do not appear to have the necessary sensitivity to predict F exposure in individuals. [ABSTRACT FROM AUTHOR]

Background: Toenail dystrophies are among the most common diseases in adulthood. Onychomycosis is one of the most frequently observed infectious diseases of the nail. Aim: The aim of this study was to determine the prevalence of fungal agents in the etiology of nail dystrophies such as discoloration, thickening, subungual hyperkeratosis, and onycholysis in toenails and to emphasize the importance of diagnosis by other laboratory confirmation tests since various nail diseases may mimic onychomycosis. Subjects and Methods: Nail samples taken from 53 patients who were admitted to the dermatology clinic with the complaint of toenail disorders were examined by using potassium hydroxide mount, fungal culture, and matrix‐assisted laser desorption/ionization time‐of‐flight mass spectrometry methods. Each nail was photographed, and descriptive analysis of the data was performed. Results: Of 53 patients included in the study, 39 were female (73.6%) and 14 were male (26.4%). The ages of the patients ranged from 14 to 70 years, and the mean age was 37.8 years. No fungi could be isolated in 17 (32%) patients with nail dystrophy, while fungal pathogens were observed in 36 (68%) patients on potassium hydroxide mount, culture, and matrix‐assisted laser desorption/ionization time‐of‐flight mass spectrometry examinations. Among nondermatophyte molds, Aspergillus species (52.7%) were identified as the most common fungal pathogen causing onychomycosis. Conclusion: Although fungal pathogenic agents are mostly detected among the diseases causing color changes and deformities in the nails, it should be kept in mind that nail findings of systemic or other skin diseases may mimic onychomycosis and the diagnosis should be confirmed by laboratory tests in addition to clinical manifestations for accurate treatment. Study Limitations: Other systemic diseases causing nail dystrophy were not questioned in the study. [ABSTRACT FROM AUTHOR]

Objective To compare efficacy of continuous terbinafine versus intermittent itraconazole in the treatment of onychomycosis. Methods This randomized controlled trial was conducted in the Department of Dermatology Nishtar Medical College and Hospital Multan from 20-05-2018 to 20-11-20. A total of 64 patients meeting inclusion criteria were randomly allocated in to two groups by lottery method. Group A, having 32 patients, was treated with 250 mg terbinafine, given orally once daily for 12 weeks while group B, having 32 patients, was treated with itraconazole 400 mg per day (orally twice a day as 200 mg per dose), given intermittently for one week per month followed by a 3 week drug free period for a total duration of 12 weeks. Patients were called for follow up at 16 week and efficacy was documented. Results Of these 64 study cases, 39 (60.9 %) were male patients while 25 (39.1 %) were female patients. Mean age of our study cases was 52.67±9.09 years. Our study results have indicated that majority of our study cases i.e. 39 (60.9 %) were aged more than 50 years. Mean disease duration was 4.45±2.53 years and 57 (89.1 %) had duration of illness more than 1 year. Efficacy was noted in 33 (51.6%) of our study cases, it was 23 (71.9%) in group A while efficacy was noted in 10 (31.2%) in group B patients (p=0.002). Conclusion Our study results support the use of oral terbinafine in the treatment of toenail onychomycosis as compared with intermittent itraconazole as oral terbinafine was significantly highly efficacious. [ABSTRACT FROM AUTHOR]

Yellow nail syndrome (YNS) can induce bilateral exudative pleural effusion; however, to the best of our knowledge, no standard treatment for YNS has been established. The present study describes a patient with YNS for whom the pleural effusion was controlled by prednisolone. A 73-year-old man was referred to the University of Tsukuba Hospital (Ibaraki, Japan) complaining of shortness of breath, which was diagnosed as being due to bilateral pleural effusion. Based on the presence of yellowing and growth retardation of the toenails, lymphedema, bilateral exudative pleural fluid of unknown etiology, and lymphatic congestion on lymphoscintigraphy, the patient was diagnosed with YNS. The pleural fluid was predominantly lymphocytic and responded to systemic steroid administration [prednisolone 30 mg/day (0.5 mg/kg) for 2 weeks, with subsequent weekly tapering]. The general condition of the patient and their dyspnea also improved with treatment. These findings indicated that systemic steroid administration should be considered as one of the treatment options for patients with YNS who are reluctant to undergo chest drainage or pleurodesis due to the potential for a decrease in their ability to perform daily activities and respiratory function. [ABSTRACT FROM AUTHOR]

• Contamination by body fluid is possible with ostarine. • Description of the first AAF with body fluid contamination. • Urine quantification of ostarine after controlled body fluid contamination. Ostarine, also known as MK-2866 or enobosarm, is a selective androgen receptor modulator (SARM). It has anabolic properties and as such is widely used in doping, accounting in 2021 for 25 % of the adverse analytical findings (AAF) among the class S1.2 "Other anabolic agents" of products banned by the World Anti-Doping Agency, to which it belongs. But in some cases, it can be responsible for an AAF following contamination. We report the case of an athlete who contaminated herself by exchanging body fluids while kissing her boyfriend, who took 25 mg per day of MK-2866 for 9 days prior to the athlete's AAF (urinary concentration evaluated at 13 ng/mL) without her knowledge. Both subjects came to our lab for hair testing. The athlete's hair was black and slightly frizzy. Six segments of 2 cm then 7 × 3 cm (33 cm) were analysed and showed increasing concentrations, from 2 pg/mg on the first segment to 17.8 pg/mg on the last segment. The boyfriend's hair, light-brown, analyzed on 4 × 2 cm, also showed increasing values, from 65 to 143 pg/mg. These gradients of concentration in the hair's athlete and in her boyfriend were compatible with external contamination of the hair, confirmed by analysis of washing baths, pillowcases (150 pg on each), and the athlete's hairbrush (250 pg). Fingernails were also contaminated, with 21 pg/mg in the athlete and 1041 pg/mg in the boyfriend, with highly contaminated washing baths, and toenails were less contaminated, with 2 pg/mg in the athlete and 17.3 pg/mg in the boyfriend. Urine samples taken 35 days after the start of MK-2866 treatment showed a value of 3690 ng/mL in the boyfriend and 5.7 ng/mL in the athlete. After 6 days off, these concentrations were 3.3 ng/mL and 0.1 ng/mL, respectively. A controlled transfer study was carried out 12 days after discontinuation (urine concentrations returned to negative level). After administration of 17 mg (the 25 mg/mL vial having been controlled at 17 mg/mL), urine samples were taken from the boyfriend and the athlete (n = 10 for each) for more than 25 h after they had been living normally with each other (regular kissing in particular). The boyfriend's urine concentrations ranged from 681 ng/mL to 12822 ng/mL (Tmax = 8:30 hrs), and the athlete's from 0.3 ng/mL to 13 ng/mL with Tmax = 8:30 hrs, i.e. at 22:30 hrs, which corresponded exactly to the time of collection of the urine that showed AAF, with a similar concentration. The dose ingested by the athlete was estimated at 15 µg. These results demonstrate the transfer of ostarine via body fluids between two subjects, with a high risk of AAF in one athlete, as observed in our case. [ABSTRACT FROM AUTHOR]

Some researchers have suggested that zinc (Zn) could reduce the risk of prostate cancer (PC). However, research from observational studies on the relationship between PC risk and biomarkers of Zn exposure shows conflicting results. To evaluate the association between toenail Zn and PC, considering tumour extension and aggressiveness, along with a gene-environment approach, exploring the interaction of individual genetic susceptibility to PC in the relationship between toenail Zn and PC. In MCC-Spain study we invited all incident PC cases diagnosed in the study period (2008–2013) and recruited randomly selected general population controls. In this report we included 913 cases and 1198 controls with toenail Zn determined by inductively coupled plasma mass spectrometry. To measure individual genetic susceptibility, we constructed a polygenic risk score based on known PC-related single nucleotide polymorphisms. The association between toenail Zn and PC was explored with mixed logistic and multinomial regression models. Men with higher toenail Zn had higher risk of PC (OR quartile 4 vs.1: 1.41; 95% CI: 1.07–1.85). This association was slightly higher in high-grade PC [(ISUP≤2 Relative risk ratio (RRR) quartile 4 vs.1: 1.36; 1.01–1.83) vs. (ISUP3-5 RRR quartile 4 vs.1: 1.64; 1.06–2.54)] and in advanced tumours [(cT1-cT2a RRR quartile 4 vs.1: 1.40; 95% CI: 1.05–1.89) vs. (cT2b-cT4 RRR quartile 4 vs.1: 1.59; 1.00–2.53)]. Men with lower genetic susceptibility to PC were those at higher risk of PC associated with high toenail Zn (OR quartile 4 vs.1: 2.18; 95% CI: 1.08–4.40). High toenail Zn levels were related to a higher risk for PC, especially for more aggressive or advanced tumours. This effect was stronger among men with a lower genetic susceptibility to PC. [Display omitted] • Although Zn is an essential element for the prostate gland, its role in the development of prostate cancer remains unclear. • The association between Zn exposure and prostate cancer may differ depending on individual genetic risk for prostate cancer. • Men with higher toenail Zn had higher risk of prostate cancer. • The association between toenail Zn and prostate cancer was higher in high-grade prostate cancers and in advance tumours. • Men with lower genetic susceptibility to PC were those at higher risk of prostate cancer associated with high toenail Zn. [ABSTRACT FROM AUTHOR]

According to our study, higher-intensity pain and prolonged time of treatment were observed in patients with history of surgical intervention for ingrown great toenail. Keywords: nail cosmetics; nail disorders; treatment EN nail cosmetics nail disorders treatment 2674 2676 3 06/23/22 20220601 NES 220601 CONFLICT OF INTEREST The authors report no conflict of interest. Complete symptom resolution was observed in 114 patients, and symptom reduction to stages 1 and 2 was found in 4 and 2 patients, respectively. [Extracted from the article]

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Objective: Onychomycosis (OM) is a common disease that covers both tinea unguium and those remaining cases caused by yeasts, mainly of the Candida and various non-dermatophyte molds. Diagnosis is usually confirmed with direct microscopy and fungal culture. Nail dermoscopy is a non-invasive tool to diagnose various nail disorders and also to avoid time-consuming investigations. The aim of the present study was to determine the dermoscoping findings in OM and to correlate this with clinical type, gender, and culture results. Materials and Methods: This was a cross-sectional study of 100 patients diagnosed with OM according to clinical findings and direct microscopic examination. Nail dermoscopy was performed using a FotoFinder Digital Dermoscope, and images were recorded. A part of the samples was cultured in all patients. Results: The most frequent clinical type was distal lateral subungual onychomycosis (80.0%). The culture was negative in 72.0% of the samples. In the positive group, 48% of Trichophyton rubrum was cultured. The most common dermoscopic findings were longitudinal stria, ruin appearance, and longitudinal leukonychia. In culture-negative samples, irregular termination was most commonly seen. Ruin appearance, brown discoloration, hematoma, and transverse leukonychia, such as brushing, were compatible with total dystrophic OM. Conclusion: Determinative dermoscopic findings for OM, clinical types, and fungus forms were identified. These signs can avoid unnecessary mycology in selected cases.