# Candidiasis of the Nails

- Category: acute
- Review status: reviewed (every claim checked against a document named on this page)
- Sources: Egyptian National Drug Formulary - Antimicrobial 2023: clotrimazole monograph states it is not effective for scalp or nails; itraconazole is licensed for dermatophyte onychomycosis and fluconazole carries no nail indication · Egyptian National Drug Formulary - antimicrobial-2023.pdf, Clotrimazole monograph (chapter PDF p400) · No dose - assessment step, no medicine given · Onychomycosis - StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK441853/
- Verified date: 2026-08

## Verified against

- No dose - assessment step, no medicine given

## Treatment metadata

- No drug therapy in primary care (Assess first)

## Complete treatment card

```text
CANDIDIASIS OF THE NAILS
Sources: Egyptian National Drug Formulary - Antimicrobial 2023: clotrimazole monograph states it is
         not effective for scalp or nails; itraconazole is licensed for dermatophyte onychomycosis
         and fluconazole carries no nail indication · Egyptian National Drug Formulary -
         antimicrobial-2023.pdf, Clotrimazole monograph (chapter PDF p400) · No dose - assessment
         step, no medicine given · Onychomycosis - StatPearls -
         https://www.ncbi.nlm.nih.gov/books/NBK441853/
Review status: REVIEWED against the source listed above  (2026-08)

1. NO DRUG THERAPY IN PRIMARY CARE (ASSESS FIRST)         [1st line]
   Adult    Confirm it before treating it. Send nail clippings for microscopy and culture: most
            thickened, discoloured nails are not candidal, and chronic paronychia, psoriasis and
            repeated trauma all look the same. Candidal nail disease is usually secondary to chronic
            paronychia in wet hands, so keeping the hands dry and treating the nail fold matters
            more than any nail preparation. - Assess, then decide
   Peds     In a child, candidal nail disease is unusual and persistent or multiple-nail candidiasis
            raises chronic mucocutaneous candidiasis or immune deficiency. Refer rather than treat.
   Source   No dose - assessment step, no medicine given
   Why      No source reachable indicates a drug for candidal nail infection. The formulary licences
            itraconazole for onychomycosis caused by DERMATOPHYTES, and fluconazole for oesophageal,
            oropharyngeal, urinary and vaginal candidiasis - neither covers the nail. Clotrimazole
            says in its own monograph: not effective for treatment of scalp or nails.
   Caution  Confirmed candidal nail disease is treated systemically and that is a dermatology
            decision - refer rather than starting an oral antifungal on a clinical guess.
            Look at the nail fold. Candidal nail disease usually follows chronic paronychia, and
            without keeping the hands dry it returns whatever is prescribed.
            A single dark streak in one nail is subungual melanoma until proved otherwise - refer
            urgently.
            In a diabetic, any nail or nail-fold infection is a foot-care problem first.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.
```

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Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement.

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