While ringworm of several or more toe-nails is frequent and ring-worm of even fewer nails of the hands infrequent, ringworm of all the nails is one of the rarest of dermatologic phenomena.
In a recent review of the 312 cases of ringworm of the nails available in the dermatologic literature of English, I1 found that in the 42 cases that were so reported as to lend themselves to statistical study the average number of diseased nails of both the hands and the feet in males and females combined was 8.97. This average is from two to four times higher than the prevailing estimate by the authors of standard textbooks.
Therefore, involvement of all 20 nails in a single additional instance is worthy of a report.
The appearance of the individual nails in onychomycosis universalis is essentially the same as in onychomycosis of the subuniversal group. The
KITTREDGE HE. ONYCHOMYCOSIS UNIVERSALIS TRICHOPHYTINA ET EPIDERMOPHYTA: REPORT OF THE SEVENTH CASE THUS FAR RECORDED IN ENGLISH. Arch Derm Syphilol. 1936;34(3):398–410. doi:10.1001/archderm.1936.01470150048004
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