Toenail onychomycosis:
highly prevalent and challenging to treat1-3

  • Onychomycosis is a common, progressive fungal infection of the nail that can eventually affect the entire nail1,4

80%–90% of onychomycosis cases are caused by dermatophytes, most notably Trichophyton rubrum and Trichophyton mentagrophytes4

Image of Trichophyton rubrum

Trichophyton rubrum

Image of Trichophyton mentagrophytes

Trichophyton mentagrophytes

  • Even after successful treatment, clinical recurrence may occur5
    •  One study demonstrated a 21% to 48% rate of clinical recurrence after successful treatment

References: 1. Vlahovic TC, Dawes CL. Myths in treating onychomycosis. In: Tosti A, Vlahovic TC, Arenas R, eds. An Illustrated Guide to Diagnosis and Treatment. Switzerland: Springer International Publishing; 2017:200-207. 2. Onychomycosis. In: Usatine RP, Smith MA, Chumley HS, Mayeaux EJ, eds. The Color Atlas of Family Medicine. 2nd ed. China: The McGraw-Hill Companies, Inc; 2013:1-12. 3. Fungal nail infections. Centers for Disease Control and Prevention website. http://www.cdc.gov/fungal/nail-infections.html. Accessed November 2, 2017. 4. Freedman JB, Tosti A. Fungi and the nails. In: Tosti A, Vlahovic TC, Arenas R, eds. An Illustrated Guide to Diagnosis and Treatment. Switzerland: Springer International Publishing; 2017:1-8. 5. Sigurgeirsson B, Olafsson JH, Steinsson JB, et al. Long-term effectiveness of treatment with terbinafine vs itraconazole in onychomycosis: a 5-year blinded prospective follow-up study. Arch Dermatol. 2012;138(3):353-357.

Epidemiology of onychomycosis

Onychomycosis occurs in one out of ten people

Onychomycosis occurs in about 
1 in 10 people1

Toenails are affected by onychomycosis four times more than fingernails

Toenails are affected more often than fingernails2

References: 1. Vlahovic TC, Dawes CL. Myths in treating onychomycosis. In: Tosti A, Vlahovic TC, Arenas R, eds. An Illustrated Guide to Diagnosis and Treatment. Switzerland: Springer International Publishing; 2017:200-207. 2. Mayo Clinic Staff. Nail fungus. Mayo Clinic website. http://www.mayoclinic.org/diseases-conditions/nail-fungus/symptoms-causes/dxc-20342473. July 26, 2017. Accessed October 2, 2017.

Risk factors for onychomycosis

Some individuals are more likely to be infected with onychomycosis.

Genetic, behavioral, and
environmental factors1-5

  • Age ≥50 years
  • Family members with onychomycosis
  • History of nail trauma
  • Shared bathing facilities
  • Smoking
  • Wearing occlusive footwear

Chronic disorders1,6,7

  • Diabetes
  • Gastrointestinal disorders
  • Primary immunosuppression (HIV/AIDS)
  • Rheumatic disorders
  • Cancer

Pre-existing atopic, skin, and fungal disorders1

  • Angioedema
  • Asthma
  • Existing fungal infection such as tinea pedis
  • Psoriasis
  • Urticaria

References: 1. Sigurgeirsson B, Steingrímsson O. Risk factors associated with onychomycosis. J Eur Acad Dermatol Venereol. 2004;18(1):48-51. 2. Ameen M, Lear JT, Madan V, Mohd Mustapa MF, Richardson M. British Association of Dermatologists’ guidelines for the management of onychomycosis 2014. Br J Dermatol. 2014;171(5):937-958. 3. Gupta AK, Gupta MA, Summerbell RC, et al. The epidemiology of onychomycosis: possible role of smoking and peripheral arterial disease. J Eur Acad Dermatol Venereol. 2000;14(6):466-469. 4. Onychomycosis. In: Usatine RP, Smith MA, Chumley HS, Mayeaux EJ, eds. The Color Atlas of Family Medicine. 2nd ed. China: The McGraw-Hill Companies, Inc; 2013:1-12. 5. Jacobsen AA, Tosti A. Predisposing factors for onychomycosis. In: Tosti A, Vlahovic TC, Arenas R, eds. An Illustrated Guide to Diagnosis and Treatment. Switzerland: Springer International Publishing; 2017:9-17. 6. Gupta AK, Konnikov N, MacDonald P, et al. Prevalence and epidemiology of toenail onychomycosis in diabetic subjects: a multicentre survey. Br J Dermatol. 1998;139(4):665-671. 7. Cribier B, Mena ML, Rey D, et al. Nail changes in patients infected with human immunodeficiency virus: a prospective controlled study. Arch Dermatol. 1998;134(10):1216-1220.

Signs and symptoms of toenail onychomycosis

Discoloration of the toenails caused by onychomycosis, Subungual hyperkeratosis caused by onychomycosis, Onycholycosis (separation of the nail plate from the nail bed) caused by onychomycosis
  • Yellow-white or yellow-brown discoloration of the nails1,2
  • Subungual hyperkeratosis1
  • Onycholycosis (separation of the nail plate from the nail bed)1
'Subungual hyperkeratosis

References: 1. Piraccini BM. Nail disorders due to dermatological diseases. In: Nail disorders: a practical guide to diagnosis and management. Bologna, Italy: Springer-Verlag Italia; 2014:75-93. 2. Mayo Clinic Staff. Nail fungus. Mayo Clinic website. http://www.mayoclinic.org/diseases-conditions/nail-fungus/symptoms-causes/dxc-20342473. July 26, 2017. Accessed October 2, 2017. 
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Important Safety Information

KERYDIN® (tavaborole) is for topical use only and not for oral, ophthalmic, or intravaginal use. The most commonly reported adverse events involved skin reactions in the application area, including exfoliation, ingrown toenail, erythema, and dermatitis.

During post-marketing use of KERYDIN®, the most commonly reported adverse events involved hypersensitivity and contact allergy.

Safety and effectiveness have not been established in pregnant or breastfeeding women or pediatric patients less than 6 years of age.

See Full Prescribing Information for KERYDIN®.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.FDA.gov/medwatch or call 1-800-FDA-1088.

Indication

KERYDIN® is an oxaborole antifungal indicated for the topical treatment of onychomycosis of the toenails due to Trichophyton rubrum or Trichophyton mentagrophytes.

Important Safety Information

KERYDIN® (tavaborole) is for topical use only and not for oral, ophthalmic, or intravaginal use. The most commonly reported adverse events involved skin reactions in the application area, including exfoliation, ingrown toenail, erythema, and dermatitis.

During post-marketing use of KERYDIN®, the most commonly reported adverse events involved hypersensitivity and contact allergy.

Safety and effectiveness have not been established in pregnant or breastfeeding women or pediatric patients less than 6 years of age.

See Full Prescribing Information for KERYDIN®.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.FDA.gov/medwatch or call 1-800-FDA-1088.

Indication

KERYDIN® is an oxaborole antifungal indicated for the topical treatment of onychomycosis of the toenails due to Trichophyton rubrum or Trichophyton mentagrophytes.

Rotate your phone for Important Safety Information.

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