[Every fith patient needs antimycotic therapy. Fungal epidemic of the nail bed].

More than 80% of cases of mycotic nail diseases are caused by the dermatophyte T. rubrum, which is becoming ever more widespread. In the majority of cases, onychomycoses affect the nails of the feet, where they are particularly favored by primary mycoses close to the nail, as well as warm, moist environment and repeated minor traumatization. A differentiation is made between distolateral onychomycosis and proximal subungual, white superficial and dystrophic onychomycoses, the latter being the terminal stage of the other forms. Differentiation of the pathogen is of importance for treatment. Depending on the nature and spread of the pathogen, management comprises systemic and/or topical antimycotic therapy followed by disinfection of shoes and socks. Furthermore, atraumatic removal of the diseased body of the nail is recommended. Surgical extraction of the nail, in contrast, is no longer indicated.