All toenail fungal infections are not created equal
Introduction to the Onychomycosis Severity Index (OSI) Onychomycosis, a common disease of the nail unit caused by dermatophytes, nondermatophyte molds, and yeasts, has a prevalence of approximately 10-20% worldwide. Currently no standardized system exists to clinically grade the severity of onychomycotic nail disease. Such a scale is necessary for clinical trial inclusion criteria, for critical evaluation of treatment choice, and to help predict therapeutic outcome. Having quantitative numbers can also assist when discussing these factors with patients and other clinicians. Inconsistences in onychomycotic grading systems can also lead to confusion about interpretation of efficacy. Recently, in a trial of ciclopirox…