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  • Ivan Bristow

Fungal Nails - how do you measure yours?

Fungal nail infection is a common condition treated by chiropodists and podiatrists. At the outset of treatment, the name of the game is to "cure" the nail of infection and restore it to its natural appearance. Establishing the diagnosis is important before treating and this can be conducted using nail samples sent to the lab or using the the dermatophyte test strip.

Once an infection has been confirmed, a cure is what being sought. Repeating the mycology testing at the end of the treatment plan one would hope for a negative result - demonstrating the fungal infection has cleared. This is what is known as a "mycological" cure . However, most patients are seeking a visual improvement in their nails and this can be more tricky to measure. A nail which looks 100% normal after the infection has been eradicated is termed as a "clinical" cure. Its no surprise to learn that clinical cure rates are much lower than mycological cure rates as often nails do not getting fully restored after the infection has gone because of previous trauma.

In clinic however, there is a way to measure clinical improvement in fungal nails. The system is known as the Onychomycosis Severity Index, or OSI for short. Developed in 2011, this simple process allows a researcher or clinician to assign a score to a nail. Useful if you want to measure improvements in nails undergoing anti-fungal treatments. Below, I have included a video outlining what it is and how to use it.

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