The anticipated accrual will be 80 patients in total. Screening Patients will participate in a screening visit as part of routine care. Informed consent will be obtained before any screening procedures. During this visit, toenail clippings will be sent for KOH stain and fungal culture. The results of these tests will be available in approximately 4 weeks. The results will be reviewed 6 weeks after the clippings are collected, and if the results are negative the patient will be excluded from study.