Management of Nail Disease by Philippine Dermatologists: A Cross-sectional Study

Background: Nail disorders, comprising around 10% of dermatological cases, can arise at any age. There is no current data on the management patterns of Filipino dermatologists regarding nail diseases in the Philippines. Aims: This study aims to identify the management patterns of board-certified Filipino dermatologists categorized as private practice dermatologist, public government dermatologist, and combined practice dermatologist for common nail diseases and assess whether their approaches align with current clinical guidelines. Settings and Design: A cross-sectional analytic design was employed, with data collected through a validated online questionnaire distributed to Philippine Dermatological Society board-certified dermatologists. Materials and Methods: A structured questionnaire was electronically distributed to Filipino dermatologists, gathering data on the types of nail conditions encountered and the treatment modalities employed, from July to October 2022. Statistical Analysis Used: Sample size was calculated with a 95% confidence level and an 8% margin of error, yielding 159 participants. Descriptive statistics using frequency and percentage were used to summarize the data. STATA 15.0 was utilized for analysis. Results: There were 221 dermatologists who participated; 65.2% are in private practice, 5.4% work exclusively for the government, and 29.4% are in both private and public practice. The most common nail disorders managed were onychomycosis, periungual warts, and nail psoriasis. Management approaches varied by practice setting. Discrepancies between practice habits and guidelines, particularly in treating conditions such as paronychia and antifungal use, highlight the need for updated information and access to advanced treatments, especially in resource-limited settings. Conclusions: Filipino dermatologists generally follow global guidelines for managing nail diseases, but treatment choices are influenced by factors such as clinical presentation and resource availability, which differ between private, government, and combined practices. While private practitioners often refer to surgical cases such as onychocryptosis, government dermatologists tend to handle them themselves. Despite these challenges, dermatologists adapt pragmatically to provide effective care.