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Description

Carney et al developed the Onychomycosis Severity Index (OSI) for grading the severity of onychomycosis that is involving a nail.. The authors are from the University of Alabama at Birmingham, Columbia University, University of North Carolina at Chapel Hill, Oregon Health and Science University, University of Miami, University of Mississippi and the University of Alabama at Tuscaloosa.


Parameters:

(1) area of nail involved

(2) percent of nail length involved, measured from distal edge

(3) dermatophytoma or significant subungual hyperkeratosis

 

percent of nail length involved =

= (length of nail involvement measured from distal end) / (nail length) * 1005

 

Parameter

Finding

Points

area of nail involved

none

0

 

1 to 10%

1

 

11 to 25%

2

 

26 to 50%

3

 

51 to 75%

4

 

76 to 100%

5

percent of nail length involved

< 25%

1

 

25 to 50%

2

 

51 to 75%

3

 

> 75%

4

 

matrix involved

5

high risk features

dermatophytoma OR subungual hyperkeratosis > 2 mm

10

 

neither present

0

 

where:

• The area of nail involved and percent of nail length are linked since the area involves the length of the nail involved.

• Involvement of the lunula and/or proximal nail fold indicates matrix involvement.

 

total score =

= ((points for area involved) * (points for percent of nail length)) + (high risk features)

 

Interpretation:

• minimum score: 0

• maximum score: 35

• The higher the score the more severe the disease.

 

Total Score

Onychomycosis

0

cured

1 to 5

mild

6 to 15

moderate

16 to 35

severe

 


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