Tinea unguium
diseaseOn this page
Also known as dermatophytic onychiadermatophytosis of nailnail dermatophytosisonychomycosis
Summary
Tinea unguium (MONDO:0001628) is a disease with 47 GWAS associations across 7 studies and 104 clinical trials. Top therapeutic interventions include terbinafine, amorolfine, and tavaborole. A subtype of dermatophytosis — broader associated-gene and molecular evidence is on the parent page (see Disease family below).
At a glance
- GWAS associations: 47
- Clinical trials: 104
Clinical features
No curated clinical features (Orphanet) for this disease.
Identifiers
Disease identifiers
| Field | Value |
|---|---|
| Canonical name | tinea unguium |
| Mondo ID | MONDO:0001628 |
| MeSH | D014009 |
| DOID | DOID:13074 |
| ICD-10-CM | B35.1 |
| NCIT | C112214 |
| UMLS | C0040261 |
| MedGen | 11825 |
| Anatomy (UBERON) | UBERON:0001705 |
| Is cancer (heuristic) | no |
Also known as: dermatophytic onychia · dermatophytosis of nail · nail dermatophytosis · onychomycosis · tinea unguium
Data availability: 47 GWAS associations (7 studies).
Disease family
This is a subtype of dermatophytosis. Genetic, therapeutic, and trial evidence is largely curated at the broader-term level — see the parent page for the associated-gene cohort and molecular evidence.
Classification path: disease › human disease › disease by etiologic mechanism › disease of primarily extrinsic mechanism › infectious disease › fungal infectious disease › cutaneous mycosis › tinea infection › dermatophytosis › tinea unguium
Related subtypes (10): tinea barbae, ectothrix infectious disease, endothrix infectious disease, dermatophytosis of groin and perianal area, tinea corporis, tinea profunda, tinea manuum, dermatophytosis of scalp or beard, tinea pedis, Majocchi granuloma
Genetics & variants
GWAS landscape
47 GWAS associations across 7 studies. Top hits map to 24 distinct genes (as reported by GWAS).
Top associations by p-value
| rsID | p-value | Gene | Risk allele | Odds ratio |
|---|---|---|---|---|
| rs17839568 | 4e-51 | PRSS53 | C | 0.07 |
| rs1421085 | 4e-45 | FTO | T | 0.08 |
| rs11642015 | 2e-38 | FTO | C | 0.08 |
| chr16:31099859 | 2e-31 | G | 0.07 | |
| rs1794269 | 5e-25 | HLA-DQB1 - MTCO3P1 | T | 0.05 |
| rs115288876 | 1e-21 | NBPF18P - S100A11 | A | 0.12 |
| rs12123821 | 8e-20 | CCDST | C | 0.13 |
| rs1829637 | 8e-18 | KRT77 | A | 0.04 |
| rs61816761 | 1e-17 | FLG, CCDST | G | 0.2 |
| rs1295685 | 5e-17 | IL13, TH2LCRR | G | 0.04 |
| rs9272364 | 1e-15 | HLA-DQA1 | G | 0.05 |
| rs35273427 | 2e-15 | ADAM30 | C | 0.06 |
| rs7903146 | 1e-14 | TCF7L2 | C | 0.04 |
| rs3787092 | 1e-14 | RTEL1, RTEL1-TNFRSF6B | T | 0.04 |
| rs112088479 | 3e-14 | NOTCH2 | T | 0.05 |
| rs2493389 | 7e-14 | NOTCH2 | C | 0.06 |
| chr1:120436751 | 6e-13 | T | 0.08 | |
| rs883312 | 2e-12 | RPS20P10 - CYP26B1 | C | 0.03 |
| rs12958073 | 2e-12 | DSCAS | A | 0.03 |
| chr17:44096553 | 4e-12 | G | 0.05 | |
| chr12:54268410 | 9e-12 | C | 0.05 | |
| rs439223 | 1e-11 | ARRDC2 - RPS18P13 | A | 0.05 |
| chr1:113108464 | 2e-11 | C | 0.05 | |
| rs112744060 | 2e-11 | RSKR, FOXN1 | T | 0.07 |
| rs4689388 | 4e-11 | JAKMIP1-DT - WFS1 | G | 0.04 |
| rs184587444 | 4e-11 | SPRR2B - SPRR2E | T | 0.14 |
| rs12037853 | 1e-10 | SLC25A38P1 - AIMP1P2 | G | 0.03 |
| rs10094888 | 1e-10 | LYPD2 - LYNX1-SLURP2 | T | 0.03 |
| rs2696618 | 6e-10 | MAPK8IP1P1 - ARL17B | G | 0.04 |
| rs12728311 | 1e-09 | ST7L | A | 0.03 |
Top studies (by case count)
| Study | Lead author | Year | Cases | Controls | Title |
|---|---|---|---|---|---|
| GCST90475562 | Verma A | 2024 | 74,612 | 343,052 | Diversity and scale: Genetic architecture of 2068 traits in the VA Million Veteran Program. |
| GCST90477146 | Verma A | 2024 | 28,312 | 82,778 | Diversity and scale: Genetic architecture of 2068 traits in the VA Million Veteran Program. |
| GCST90479765 | Verma A | 2024 | 28,312 | 82,778 | Diversity and scale: Genetic architecture of 2068 traits in the VA Million Veteran Program. |
| GCST90477145 | Verma A | 2024 | 10,074 | 44,970 | Diversity and scale: Genetic architecture of 2068 traits in the VA Million Veteran Program. |
| GCST90481459 | Verma A | 2024 | 450 | 6,087 | Diversity and scale: Genetic architecture of 2068 traits in the VA Million Veteran Program. |
| GCST90435558 | Zhou W | 2018 | 76 | 406,301 | Efficiently controlling for case-control imbalance and sample relatedness in large-scale genetic association studies. |
| GCST90809870 | Haapaniemi H | 2026 | 0 | 0 | The genetic basis of dermatophytosis skin infection susceptibility. |
Variant details and genetic-evidence tiers
Tier distribution (top 50 variants)
| Tier | Variants |
|---|---|
| Tier 1: coding | 3 |
| Tier 2: splice/UTR | 3 |
| Tier 3: regulatory | 0 |
| Tier 4: intronic/intergenic | 37 |
MAF distribution
| Bucket | Variants |
|---|---|
| common (>=0.05) | 38 |
| low_freq (0.01-0.05) | 5 |
| rare (<0.01) | 0 |
| unknown | 0 |
Functional consequences
| Consequence | Count |
|---|---|
| intron_variant | 20 |
| intergenic_variant | 10 |
| unknown | 5 |
| 3_prime_UTR_variant | 3 |
| missense_variant | 2 |
| non_coding_transcript_exon_variant | 2 |
| stop_gained | 1 |
Top variants
| rsID | Chr | Pos | Alleles | MAF | Consequence | Gene | p-value | Tier |
|---|---|---|---|---|---|---|---|---|
| rs17839568 | 16 | 31088462 | T>C | 0.42 | intron_variant | PRSS53 | 4e-51 | Tier 4: intronic/intergenic |
| rs1421085 | 16 | 53767042 | T>C | 0.407 | intron_variant | FTO | 4e-45 | Tier 4: intronic/intergenic |
| rs11642015 | 16 | 53768582 | C>G,T | 0.329 | intron_variant | FTO | 2e-38 | Tier 4: intronic/intergenic |
| chr16:31099859 | 0.377 | 2e-31 | Tier 4: intronic/intergenic | |||||
| rs1794269 | 6 | 32706117 | C>G,T | 0.393 | intergenic_variant | HLA-DQB1 - MTCO3P1 | 5e-25 | Tier 4: intronic/intergenic |
| rs115288876 | 1 | 152027641 | G>A | 0.036 | intron_variant | NBPF18P - S100A11 | 1e-21 | Tier 4: intronic/intergenic |
| rs12123821 | 1 | 152206676 | C>T | 0.047 | intron_variant | CCDST | 8e-20 | Tier 4: intronic/intergenic |
| rs1829637 | 12 | 52695529 | G>A,C,T | 0.295 | intron_variant | KRT77 | 8e-18 | Tier 4: intronic/intergenic |
| rs61816761 | 1 | 152313385 | G>A,C,T | 0.016 | stop_gained | FLG, CCDST | 1e-17 | Tier 1: coding |
| rs1295685 | 5 | 132660753 | A>G,T | 0.259 | 3_prime_UTR_variant | IL13, TH2LCRR | 5e-17 | Tier 2: splice/UTR |
| rs9272364 | 6 | 32636822 | G>A | 0.29 | intergenic_variant | HLA-DQA1 | 1e-15 | Tier 4: intronic/intergenic |
| rs35273427 | 1 | 119894128 | T>C | 0.096 | missense_variant | ADAM30 | 2e-15 | Tier 1: coding |
| rs7903146 | 10 | 112998590 | C>G,T | 0.289 | intron_variant | TCF7L2 | 1e-14 | Tier 4: intronic/intergenic |
| rs3787092 | 20 | 63684240 | C>T | 0.23 | intron_variant | RTEL1, RTEL1-TNFRSF6B | 1e-14 | Tier 4: intronic/intergenic |
| rs112088479 | 1 | 120091480 | C>T | 0.134 | intergenic_variant | NOTCH2 | 3e-14 | Tier 4: intronic/intergenic |
| rs2493389 | 1 | 119931555 | C>A,G,T | 0.139 | intron_variant | NOTCH2 | 7e-14 | Tier 4: intronic/intergenic |
| chr1:120436751 | 0.063 | 6e-13 | Tier 4: intronic/intergenic | |||||
| rs883312 | 2 | 72012632 | T>C,G | 0.424 | intergenic_variant | RPS20P10 - CYP26B1 | 2e-12 | Tier 4: intronic/intergenic |
| rs12958073 | 18 | 31231114 | G>A | 0.465 | intron_variant | DSCAS | 2e-12 | Tier 4: intronic/intergenic |
| chr17:44096553 | 0.217 | 4e-12 | Tier 4: intronic/intergenic | |||||
| chr12:54268410 | 0.211 | 9e-12 | Tier 4: intronic/intergenic | |||||
| rs439223 | 19 | 18015644 | G>A | 0.099 | intergenic_variant | ARRDC2 - RPS18P13 | 1e-11 | Tier 4: intronic/intergenic |
| chr1:113108464 | 0.199 | 2e-11 | Tier 4: intronic/intergenic | |||||
| rs112744060 | 17 | 28538268 | C>A,T | 0.045 | 3_prime_UTR_variant | RSKR, FOXN1 | 2e-11 | Tier 2: splice/UTR |
| rs4689388 | 4 | 6268329 | G>A | 0.414 | intergenic_variant | JAKMIP1-DT - WFS1 | 4e-11 | Tier 4: intronic/intergenic |
| rs184587444 | 1 | 153079185 | C>T | 0.015 | intron_variant | SPRR2B - SPRR2E | 4e-11 | Tier 4: intronic/intergenic |
| rs12037853 | 1 | 172883263 | A>C,G | 0.27 | intron_variant | SLC25A38P1 - AIMP1P2 | 1e-10 | Tier 4: intronic/intergenic |
| rs10094888 | 8 | 142762416 | C>T | 0.359 | intron_variant | LYPD2 - LYNX1-SLURP2 | 1e-10 | Tier 4: intronic/intergenic |
| rs2696618 | 17 | 46248269 | C>G,T | 0.269 | intron_variant | MAPK8IP1P1 - ARL17B | 6e-10 | Tier 4: intronic/intergenic |
| rs12728311 | 1 | 112601817 | G>A | 0.232 | intron_variant | ST7L | 1e-09 | Tier 4: intronic/intergenic |
Genes & proteins
No associated-gene cohort resolved for this disease. Atlas builds the molecular and therapeutic sections — associated genes, protein families, druggability, pathways, interactions, and drug associations — by aggregating over a disease’s associated genes (resolved via GWAS / GenCC / ClinVar / CIViC), and none resolved here. This is expected for antibody-mediated, autoimmune, or otherwise non-gene-defined conditions; the curated evidence for this disease is its clinical features, GWAS susceptibility, and clinical trials (above).
Function
No pathway enrichment — requires an associated-gene cohort.
Therapeutics
Drugs indicated for this disease
5 approved, 2 in late-stage (phase 3) trials. Disease-direct ChEMBL indications, not inferred from the associated-gene cohort below.
| Drug | Development status |
|---|---|
| Ciclopirox | Approved (phase 4) |
| Efinaconazole | Approved (phase 4) |
| Itraconazole | Approved (phase 4) |
| Tavaborole | Approved (phase 4) |
| Terbinafine | Approved (phase 4) |
| Amorolfine | Phase 3 (in late-stage trials) |
| Bifonazole | Phase 3 (in late-stage trials) |
Earlier-phase candidates (phase 2, investigational — efficacy not yet established): Luliconazole, Naftifine, Oteseconazole, Posaconazole.
Clinical trials & evidence
Clinical trials
Clinical trials: 104.
Phase distribution (across all retrieved trials)
| Phase | Trials |
|---|---|
| Not specified | 35 |
| PHASE2 | 28 |
| PHASE3 | 15 |
| PHASE1 | 13 |
| PHASE4 | 10 |
| PHASE2/PHASE3 | 2 |
| PHASE1/PHASE2 | 1 |
Top trials by phase / activity
| NCT | Phase | Status | Title |
|---|---|---|---|
| NCT01014637 | PHASE4 | UNKNOWN | Efficacy, Safety and Cost-effectiveness of a Sequential Therapy With RV4104A Ointment, Ciclopiroxolamine Cream and Ciclopirox Film-forming Solution Compared With Amorolfine Nail Lacquer in Dermatophytic Onychomycosis |
| NCT01419847 | PHASE4 | COMPLETED | Topical Penlac Nail Lacquer for Onychomycosis in Children |
| NCT01851590 | PHASE4 | COMPLETED | Resin vs. Amorolfine vs. Terbinafine Treatment in Onychomycosis |
| NCT02436291 | PHASE4 | UNKNOWN | Evaluation of the Efficacy of CURE-EX Treatment in Onychomycosis |
| NCT02464826 | PHASE4 | COMPLETED | A Pilot Study - Safety and Efficacy of Nailprotex® for Onychomycosis Treatment |
| NCT02812771 | PHASE4 | COMPLETED | Safety and Pharmacokinetics of Efinaconazole Topical Solution in Subjects With Mild to Severe Onychomycosis |
| NCT03098615 | PHASE4 | COMPLETED | Study Evaluating the Effect of Jublia on Dermatophytomas |
| NCT03405818 | PHASE4 | COMPLETED | An Evaluation of the Safety and Pharmacokinetics of Tavaborole Topical Solution for the Treatment of Fungal Disease of the Toenail in Children and Adolescents |
| NCT03814343 | PHASE4 | COMPLETED | Topical Amphotericin B in 30% Dimethylsulphoxide in Treating of Non-dermatophytes Onychomycosis |
| NCT05809297 | PHASE4 | UNKNOWN | Diode Laser and Photodynamic Therapy Vs. Ciclopirox. |
| NCT05279846 | PHASE3 | ACTIVE_NOT_RECRUITING | A Vehicle-controlled Study of Topical MOB015B in the Treatment of Distal Subungual Onychomycosis (DSO) |
| NCT00356915 | PHASE3 | COMPLETED | Itraconazole Tablets Vs. Itraconazole Capsules vs. Placebo in Onychomycosis of the Toenail. |
| NCT00443820 | PHASE3 | COMPLETED | Efficacy Safety, and Tolerability of Topical Terbinafine in Patients With Mild to Moderate Toenail Fungus of the Big Toenail |
| NCT00443898 | PHASE3 | COMPLETED | Efficacy, Safety, and Tolerability of Topical Terbinafine in Patients With Mild to Moderate Toenail Fungus of the Big Toenail |
| NCT00459537 | PHASE3 | COMPLETED | Efficacy, Safety and Tolerability of Topical 10% Terbinafine Hydrogen Chloride Versus 5% Amorolfine Nail Lacquer in Patients With Mild to Moderate Toenail Onychomycosis |
| NCT00776464 | PHASE2/PHASE3 | UNKNOWN | Treating Onychomychosis |
| NCT00781820 | PHASE3 | COMPLETED | Comparative Efficacy of Bifonazole Cream vs Placebo After Nail Ablation With Urea Paste |
| NCT00935649 | PHASE2/PHASE3 | COMPLETED | PinPointe FootLaser for the Treatment of Onychomycosis |
| NCT01007708 | PHASE3 | COMPLETED | The Safety and Efficacy of Topical IDP-108 Versus Vehicle in Patients With Onychomycosis |
| NCT01008033 | PHASE3 | COMPLETED | Safety and Efficacy of Topical IDP-108 Versus Vehicle in Patients With Onychomycosis |
| NCT01145807 | PHASE3 | UNKNOWN | TDT 067 Onychomycosis Study |
| NCT01208129 | PHASE3 | TERMINATED | Safety and Efficacy of NAB001 in the Treatment of Mild to Moderate Onychomycosis of the Toenails |
| NCT01208168 | PHASE3 | TERMINATED | Safety & Efficacy of NAB001 in the Treatment of Mild to Moderate Onychomycosis of the Toenails |
| NCT02547701 | PHASE3 | COMPLETED | Clinical Trial on Onychomycosis With P-3058 Nail Solution in Pediatric Population |
| NCT02549001 | PHASE3 | COMPLETED | Study to Evaluate the Efficacy and Safety of P-3058 10% Nail Solution in the Treatment of Toenail Onychomycosis |
| NCT02961634 | PHASE3 | UNKNOWN | Study Efficacy and Safety in Comparative Use of Investigational Product Adjuvant Treatment in Onychomycosis |
| NCT03168841 | PHASE3 | COMPLETED | Efficacy and Safety of Efinaconazole 10% Solution in the Treatment of Onychomycosis in Diabetic Patients |
| NCT06327295 | PHASE2 | RECRUITING | A Study of ATB1651 in Adults With Mild to Moderate Onchomycosis |
| NCT00253305 | PHASE2 | COMPLETED | Topical Gel Anti-Fungal Agent for Tinea Unguium |
| NCT00385502 | PHASE2 | COMPLETED | A Trial of the Safety and Efficacy of EcoNail™ in the Treatment of Fungus Infections of the Great Toenail |
| NCT00453271 | PHASE2 | COMPLETED | Treatment of Mild to Moderate Distal Subungual Onychomycosis of the Toenail |
| NCT00491764 | PHASE2 | COMPLETED | A Study to Evaluate Efficacy and Safety of Four Posaconazole Regimens With Placebo and Terbinafine in the Treatment of Toenail Onychomycosis (Study P05082AM2)(COMPLETED) |
| NCT00679523 | PHASE2 | COMPLETED | Safety and Efficacy Study of Subjects With Onychomycosis of the Great Toenail |
| NCT00679601 | PHASE2 | COMPLETED | Absorption and Systemic Study of AN2690 in Patients With Moderate to Severe Onychomycosis (ADME II) |
| NCT00680134 | PHASE2 | COMPLETED | Safety and Efficacy Evaluation of Topically Applied AN2690 Solutions for Subjects With Onychomycosis |
| NCT00680160 | PHASE2 | COMPLETED | Absorption and Systemic Study of AN2690 in Patients With Moderate to Severe Onychomycosis (ADME I) |
| NCT00730405 | PHASE2 | COMPLETED | Efficacy and Safety Study of 4 Dose Regimens of Oral Albaconazole in Subjects With Distal Subungual Onychomycosis |
| NCT00771732 | PHASE2 | UNKNOWN | Using Light Therapy to Treat Toe Nail Fungus |
| NCT00777868 | PHASE2 | COMPLETED | A Dose-Ranging Study Evaluating the Safety and Efficacy of IDP-108 in Patients With Onychomycosis |
| NCT00791219 | PHASE2 | COMPLETED | Study Comparing SUBA™-Itraconazole With SPORANOX® (Itraconazole) in the Treatment of Onychomycosis |
Drugs tested across these trials (top 30)
| Molecule | Max phase | Trials referencing |
|---|---|---|
| TERBINAFINE | 4 | 15 |
| AMOROLFINE | 4 | 8 |
| TAVABOROLE | 4 | 5 |
| EFINACONAZOLE | 4 | 4 |
| CICLOPIROX | 4 | 3 |
| ITRACONAZOLE | 4 | 1 |
| OTESECONAZOLE | 4 | 1 |
| POSACONAZOLE | 4 | 1 |
| UREA | 4 | 1 |
| WATER | 4 | 1 |
| CETYLPYRIDINIUM CHLORIDE | 3 | 1 |
| SODIUM LAURYL SULFATE | 3 | 1 |
| ALBACONAZOLE | 2 | 1 |
| VEHICLE | 0 | 8 |
| CHEMBL1204779 | 0 | 1 |
| HYOSCYAMINE | -1 | 1 |