Tinea unguium
Chapter 1:Certain infectious and parasitic diseases
ICD-10 B35.1 is a billable code used to indicate a diagnosis of tinea unguium.
Tinea unguium, also known as onychomycosis, is a fungal infection that affects the nails, particularly the toenails and fingernails. It is primarily caused by dermatophytes, but can also be due to non-dermatophyte molds and yeasts. The infection typically presents as discoloration, thickening, and separation of the nail from the nail bed, leading to potential pain and discomfort. The condition is more prevalent in individuals with compromised immune systems, diabetes, or peripheral vascular disease. Diagnosis is often made through clinical examination and confirmed with laboratory tests such as nail clippings or scrapings sent for fungal culture or microscopy. Treatment options include topical antifungal agents like ciclopirox and systemic antifungals such as terbinafine or itraconazole, which are more effective for extensive infections. Given the chronic nature of tinea unguium, treatment may require several months, and adherence to therapy is crucial for successful outcomes. Patients with immunocompromised states may experience more severe manifestations and require closer monitoring and aggressive treatment strategies.
Detailed clinical notes on the appearance of the nails, history of symptoms, and any previous treatments.
Patients presenting with nail discoloration, thickening, or pain; recurrent infections.
Consideration of patient history, including immunocompromised status and previous antifungal treatments.
Foot examination findings, patient history regarding foot care, and any systemic conditions.
Patients with diabetes or peripheral vascular disease presenting with nail issues.
Importance of documenting vascular status and any foot complications.
Used when extensive nail involvement requires surgical intervention.
Document the reason for nail removal and any associated procedures.
Podiatrists may frequently perform this procedure in cases of severe onychomycosis.
Common treatments include topical antifungals like ciclopirox and systemic antifungals such as terbinafine and itraconazole, depending on the severity of the infection.
Tinea unguium typically presents with nail discoloration, thickening, and separation from the nail bed. Laboratory tests can confirm the diagnosis.
