Tinea unguium
ICD-10 B46.3 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 non-dermatophyte molds and yeasts can also be responsible. Tinea unguium is more prevalent in individuals with compromised immune systems, diabetes, or peripheral vascular disease. 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 antifungals 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 the presence of any underlying conditions. In immunocompromised patients, the risk of severe infection increases, necessitating more aggressive treatment and monitoring.
Detailed clinical notes on nail examination, treatment plans, and follow-up.
Patients presenting with nail discoloration, thickening, or pain.
Ensure accurate documentation of the type of fungus and any underlying conditions.
Comprehensive history of immunocompromised status and treatment response.
Patients with recurrent fungal infections or those with systemic symptoms.
Document any systemic treatments and their effects on the fungal infection.
Used when significant nail debris is present and requires removal.
Document the extent of debridement and the condition of the nail.
Dermatology may require specific notes on the nail's appearance post-debridement.
Tinea unguium is primarily caused by dermatophytes, but can also be due to non-dermatophyte molds and yeasts.
