Onychomycosis: Newer insights in pathogenesis and diagnosis

Onychomycosis (OM) is the commonest disorder affecting the nail unit. The fact that it affects 3-26% people worldwide goes to show that it is a significant health problem. The prevalence of OM has been reported to be increasing over the years. Although, we know much about various predisposing factors, we are yet unclear about its exact pathogenesis. The peculiarities of the nail unit with respect to its structure and its immune mechanisms make OM an adversary, which once established is difficult to eradicate. There have been many recent advances in our understanding of the pathogenesis of OM and our methods of diagnosing it. The increasingly valuable role of histopathology; refinements in its technique; PCR techniques; Optical coherence tomography and advances in spectrometric techniques have been reported. The present review is aimed at discussing the newer advances in our understanding of the pathogenesis of various clinical types of OM apart from the newer and exciting techniques of diagnosing it.