Onychomycosis is more than a cosmetic concern

In the Clinical Inquiry, “Which oral antifungal is best for toenail onychomycosis?” (J Fam Pract 2007; 56:581–582), the authors cite cosmetic concerns and local symptoms as primary reasons to treat. However, onychomycosis appears to be a risk factor for cellulitis,¹ to which diabetes patients are more prone and from which they stand to suffer the worst outcomes. Acknowledging this potential morbidity should discourage a laissez-faire attitude toward this disease for patients with risk factors for cellulitis.

Michael K. Park, MD
Associate Director, Rose Family Medicine Residency;
Assistant Professor, University of Colorado; Assistant
Editor, Family Physicians Inquiries Network; Denver, Colo
michael.park@uchsc.edu