Nevertheless, the perception still persists in the minds of many physicians that onychomycosis is more of a cosmetic nuisance than a significant disease. The prevalence of onychomycosis is rising, probably due to a combination of factors related to increased case detection and enhanced risk of infection. Dr. Drake was an author of the cited study, which appeared in the August 1999 issue of the Journal of the American Academy of Dermatology . Patients may fear injury and spreading the disease to others. The physical consequences of onychomycosis may be considerable.
Intact nails play a critical role in protecting fingers.
Also, prolonged standing and walking can be impaired by severe toenail disease. After in-depth interviews with patients to identify a range of problems that are encountered due to onychomycosis, the questionnaire was developed, paying special attention to the need for linguistic validation. One of the principal findings was that onychomycosis is perceived as impairing quality of life to a greater extent in the United States and Germany than in Italy. Other results indicated that greater impairment occurred with longer duration of the disease, and the greater extent of areas affected. Fingernail onychomycosis had a greater impact on quality of life than toenail infection, and toenail onychomycosis impaired more women than men, especially impairing older patients.