Clinical Management of Painful Onychomycosis With Functional Impairment: A Case Report at Dr Batra's

Abstract

Background

Onychomycosis is a chronic fungal infection of the nail that may cause nail dystrophy, discomfort, periungual skin changes and functional impairment. In severe symptomatic cases, pain and associated skin fissuring can interfere with routine activities.

Case Presentation

A 39-year-old male presented with a pre-diagnosed case of onychomycosis. The condition reportedly began after swimming classes. Despite previous allopathic treatment with Xorofung, Tab Apledal, Clobiol ointment and Lizole cream, initial improvement was followed by a period of limited further response. At presentation, the patient reported significant pain, itching and recurrent cuts with peeling of the skin, severe enough to interfere with routine activities and typing. He reported relief when the affected skin peeled off, although cuts subsequently recurred. Investigations showed vitamin D of 19.93 ng/mL, TSH 1.44 and cholesterol 67.7 as documented in the supplied record.

Treatment and Outcome

Individualized homeopathic management was documented, with Carcinosin selected constitutionally based on the patient's described dominant/strict paternal upbringing, and Nitric acid considered for the painful nail presentation. During follow-up, cuts progressively reduced, with improvement initially noted in three fingers and subsequently absence of skin peeling and cuts. By July 2026, the patient reported that his hands were better, with no peeling or dryness; nail changes, however, were still reported as persisting.

Conclusion

The case demonstrates longitudinal improvement in associated periungual skin symptoms and functional discomfort, while nail involvement persisted. Because the patient had previously received allopathic treatment and complete mycological confirmation is unavailable, the observed improvement cannot be attributed specifically to homeopathic treatment.