Onychomycosis differential diagnosis

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Onychomycosis must be differentiated from other diseases that cause discoloration and change in texture of the nail, such as psoriasis, and other causes.

The differential diagnosis includes

1. Inflammatory disorders such as psoriasis and lichen planus;
2. Genetic disorders such as pachyonychia congenita;
3. Nail malignancies,
4. Nail trauma
5. Drugs like antiretrovirals, cytotoxic drugs.
6. Bacterial infections
7. Systemic diseases like liver failure, uremia , connective tissue disorders, etc

A nail unit biopsy may be needed to confirm diagnosis.