Nail dystrophy caused by infectious skin diseases: a narrative review

Purpose: Nail dystrophy has a substantial impact on patients both functionally and psychologically. It can result from numerous infectious and noninfectious conditions. Among infectious causes, fungal infections are among the most common sources of nail abnormalities seen in dermatology outpatient clinics. These infections produce chronic structural changes through direct invasion of the nail plate and subungual tissue. Viral warts are another infectious cause of nail dystrophy, in which nail changes occur secondary to tissue proliferation induced by human papillomavirus infection, as well as mechanical pressure and localized inflammation. Bacterial pathogens may also contribute. This review focuses on onychomycosis and periungual warts as representative infectious causes of nail dystrophy.Current Concepts: In this review, we describe the pathophysiology, clinical manifestations, diagnostic approaches, and treatment strategies for nail dystrophy caused by fungal infections and viral warts.Discussion and Conclusion: Our aim is to improve clinical understanding and awareness of these conditions. Misdiagnosis can lead to prolonged treatment failure and patient dissatisfaction. Advances in diagnostic technologies and the development of newer antifungal agents may enhance diagnostic accuracy and therapeutic outcomes. Recognizing the broad clinical spectrum of infectious nail disorders is important for appropriate management and for optimizing patients’ quality of life.