Quality of Life in Toenail Onychomycosis

Abstract:

Onychomycosis is the most frequent nail disease, accounting for about a half of all nail abnormalities and for one third of all mycotic infections of the skin. The frequency of onychomycosis is found to be about 3–8% of general population, with toenail involvement being 4–7 times more frequent than fingernail ones. Although toenail onychomycosis is not a life-threatening disease, it cannot be considered as a cosmetic problem only. Besides many complications like bacterial cellulitis or allergic reactions, in several studies toenail onychomycosis has also been shown to significantly alter the patients’ quality of life (QoL). Numerous onychomycosis-specific questionnaires have been developed to assess QoL in onychomycosis patients as general health questionnaires usually do not identify well problems of patients with skin diseases. It was observed that affected by toenail onychomycosis persons experienced reduced self-confidence, embarrassment, and were less willing to participate in social and leisure activities. In addition, it was found that 33.4% of patients with onychomycosis had slightly decreased QoL, 30% moderately decreased, 21% severely decreased and 0.8% very severely altered QoL, while only 14.9% of patients demonstrated normal QoL. The degree of influence of toenail onychomycosis on patients’ QoL depends on several disease-related and demographic parameters, including, but not limited to duration and type of onychomycosis, number of involved toenails, age, gender, place of living, and education. Summarizing, toenail onychomycosis is a common disease which significantly influences patients’ psyche. Based on own experience and literature data it could be concluded that toenail onychomycosis causes marked decrease of QoL in a reasonable number of patients.