The impact of onychomycosis on quality of life: Development of an international onychomycosis-specific questionnaire to measure patient quality of life

Background: Onychomycosis is a widespread refractory disease deleteriously affecting quality of life via social stigma and disrupting daily activities . Many physicians perceive onychomycosis as a cosmetic rather than a medica l problem. Objective: Our purpose was to develop a questionnaire-based instrument to q uantify the impact of onychomycosis on patients' quality of life. Methods: The questionnaire was developed and validated in a multinational c ross-sectional study. Completed questionnaires from 532 patients were analy zed: 284 toenail, 248 fingernail (onychomycosis or paronychia). Results:The degree of quality of life impairment from onychomycosis varied by country studied, possibly reflecting cross-national health perception di fferences. Longer duration of disease, greater involvement of individual na ils, and greater number of nails involved were associated with more serious adverse effects. Many physicians underestimated the associated degree of p ain. Conclusion: The study confirms that onychomycosis physically and psychologi cally affects patients' lives. The questionnaire may be a valuable tool in evaluating the effect of therapeutic agents on quality of life of patients with onychomycosis.