Tinea unguium
Chapter 1:Certain infectious and parasitic diseases
ICD-10 B35.2 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, primarily the toenails but can also involve fingernails. It is characterized by nail discoloration, thickening, and potential separation from the nail bed. The infection is often caused by dermatophytes, but non-dermatophyte molds and yeasts can also be responsible. Risk factors include advanced age, diabetes mellitus, immunocompromised states, and poor circulation. Symptoms may include nail brittleness, crumbling, and a foul odor. Diagnosis is typically made through clinical examination and confirmed by laboratory tests such as nail clippings or scrapings sent for fungal culture or microscopy. Treatment options include topical antifungals like ciclopirox and systemic antifungals such as terbinafine and itraconazole, which are more effective for extensive infections. In immunocompromised patients, the risk of severe infection increases, necessitating more aggressive treatment and monitoring.
Detailed clinical notes including symptoms, duration, and treatment response.
Patients presenting with nail changes, recurrent fungal infections, or treatment failures.
Consideration of nail biopsy for definitive diagnosis in atypical cases.
Comprehensive history of immunocompromised conditions and previous treatments.
Management of onychomycosis in patients with HIV/AIDS or undergoing chemotherapy.
Close monitoring of treatment response and potential drug interactions.
Used when extensive debridement is necessary for treatment of onychomycosis.
Document the extent of debridement and the condition of the nails.
Dermatologists may perform this procedure more frequently.
Tinea unguium is primarily caused by dermatophyte fungi, but can also be caused by non-dermatophyte molds and yeasts.
