Tinea unguium
Chapter 1:Certain infectious and parasitic diseases
ICD-10 B35.3 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. It is characterized by the thickening, discoloration, and possible separation of the nail from the nail bed. The infection is primarily caused by dermatophytes, but can also be due to non-dermatophyte molds and yeasts. Tinea unguium is more prevalent in individuals with compromised immune systems, diabetes, or 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 sent for fungal culture or KOH preparation. Treatment options include topical antifungal agents like ciclopirox and systemic antifungals such as terbinafine and itraconazole. The choice of treatment may depend on the severity of the infection, the patient's overall health, and any underlying conditions that may affect the immune response.
Detailed clinical notes on the appearance of the nails and any laboratory results.
Patients presenting with nail discoloration, thickening, or pain.
Documenting the duration of symptoms and any previous treatments.
Comprehensive history of the patient's immune status and any coexisting conditions.
Immunocompromised patients with recurrent fungal infections.
Emphasizing the need for culture results to guide treatment.
Used when significant nail dystrophy is present.
Document the extent of debridement and the condition of the nails.
Dermatologists should note any underlying conditions affecting nail health.
Tinea unguium is primarily caused by dermatophytes, particularly Trichophyton rubrum, but can also be caused by non-dermatophyte molds and yeasts.