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I had a patient yesterday who had total dystrophic onychomycosis in 9 nails and the 4th right toenail was completely unaffected and of a normal appearance. After thinking, I have seen sparing of one or two nails a few times in past with other patients. Does anyone know why/how this happens ???

 

I can't recall any specific eg's, but maybe it could be a matter of time for the 10th to be affected.