Given the increased prevalence of onychomycosis in patients with diabetes and the potential risk for related complications, this author reviews confirmatory diagnostic tests and offers insights on management of the condition in this patient population.For most of us, our patients are both older and have some degree of diabetes mellitus. This special patient population often has abnormal toenails as well as the trifecta of arterial insufficiency, neuropathy and immune compromise. This perfect storm puts many of our patients at increased risk for pressure ulceration, secondary bacterial infection and subsequent toe or limb loss.1,2

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Before And After Treatment