S1 Guideline onychomycosis

J Dtsch Dermatol Ges. 2023 Jun;21(6):678-692. doi: 10.1111/ddg.14988. Epub 2023 May 22.

Abstract

Onychomycosis is a fungal infection of the fingernails and toenails. In Europe, tinea unguium is mainly caused by dermatophytes. The diagnostic workup comprises microscopic examination, culture and/or molecular testing (nail scrapings). Local treatment with antifungal nail polish is recommended for mild or moderate nail infections. In case of moderate to severe onychomycosis, oral treatment is recommended (in the absence of contraindications). Treatment should consist of topical and systemic agents. The aim of this update of the German S1 guideline is to simplify the selection and implementation of appropriate diagnostics and treatment. The guideline was based on current international guidelines and the results of a literature review conducted by the experts of the guideline committee. This multidisciplinary committee consisted of representatives from the German Society of Dermatology (DDG), the German-Speaking Mycological Society (DMykG), the Association of German Dermatologists (BVDD), the German Society for Hygiene and Microbiology (DGHM), the German Society of Pediatric and Adolescent Medicine (DGKJ), the Working Group for Pediatric Dermatology (APD) and the German Society for Pediatric Infectious Diseases (DGPI). The Division of Evidence-based Medicine (dEBM) provided methodological assistance. The guideline was approved by the participating medical societies following a comprehensive internal and external review.

Keywords: Onychomycosis; fungal nail infection; nail fungus.

Publication types

  • Review

MeSH terms

  • Administration, Oral
  • Adolescent
  • Antifungal Agents / therapeutic use
  • Child
  • Europe
  • Humans
  • Nails
  • Onychomycosis* / diagnosis
  • Onychomycosis* / drug therapy

Substances

  • Antifungal Agents