0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
The Best of the Best |

Top-Accessed Article: White Superficial Onychomycosis FREE

Caitlin K. Carney, MD; Boni E. Elewski, MD
Arch Dermatol. 2010;146(5):554. doi:10.1001/archdermatol.2010.57.
Text Size: A A A
Published online

Piraccini BM, Tosti A. White superficial onychomycosis: epidemiological, clinical, and pathological study of 79 patients. Arch Dermatol.2004;140(6):696-701.

In their article, Piraccini and Tosti better define the deep variant of white superficial onychomycosis (WSO). The authors observe deep WSO in 3 situations: (1) mold infections (particularly Fusarium species and Aspergillus species infections), (2) children with Candida or Trichophyton rubrum infection, and (3) immunocompromised patients with T rubrum infection. Deep WSO is characterized by diffuse involvement of the nail plate and presence of fungi in both the superficial and intermediate layers. Traditionally, the toenails are affected; however, in children and immunocompromised patients, deep WSO can also affect fingernails. Certain host factors may affect the severity of WSO including immune function, genetics, and local factors such as nail thickness.

Piraccini and Tosti recognize WSO as a progressive disease that may infect the entire nail plate. Onychomycosis is amenable to current therapies; however, WSO and deep WSO may pose a therapeutic challenge. Deep WSO infections require systemic therapy and may be less likely to respond to itraconazole, fluconazole, or terbinafine.

From June 2004 through August 2009, this article was viewed 4434 times on the Archives of Dermatology Web site.

Drs Carney and Elewski are with the Department of Dermatology, University of Alabama at Birmingham; contact Dr Elewski at beelewski@aol.com.

Figures

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

326 Views
4 Citations
×

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Jobs