Onychomycosis – Symptoms, Causes And Treatment
Onychomycosis, also called tinea unguium, is a fungal infection of the nail. Symptoms may involve the separation of white or yellow nail discoloration, nail thickness, and nail bedding from the nail bed. Toenails or fingernails can be affected, but it is more common to affect toenails. Complications can include cellulitis of the lower leg.
Many different types of fungi can cause Onychomycosis, including dermatophots and fossils. Risk factors include athlete’s foot, other nail disease, exposure to a person with condition, peripheral vascular disease, and poor defense work. Diagnosis is usually suspected on the basis of attendance and is confirmed by laboratory testing.
Onychomycosis does not require the necessary treatment. antifungal medication, terbinafine, appears to be the most effective from mouth but is associated with liver problems. It is also useful to trim the affected nails when on treatment. A ciclopirox-containing nail is polished, but it also does not work. After the treatment, situation comes in half the cases. Do not use old shoes after treatment can reduce the risk of recurrence.
It occurs in about 10 percent of the adult population. Old men are often affected. Males are often affected compared to females. Onychomycosis represents half of half the disease. This was the first time that in 1853 George Meissner was determined to be the result of a fungal infection.
Signs and Symptoms
The most common symptom of a fungal nail infection is the nail thickening and distorted: white, black, yellow or green. As the infection progresses, the nail can be brittle, break the pieces or completely away from the toe or finger. If untreated, then the skin around and below the nail can become swollen and painful. Nail beds or skeletal skin may also have white or yellow patches beside the nail, and the smell of a scent can also occur. There is usually no pain or other physical symptoms, unless the disease is serious. People with Onychomycosis may experience significant psychological problems due to the presence of nails, especially when fingers – which are always visible – are affected by the tunnel.
Dermatophytids fungus are free skin lesions that sometimes occur as a result of fungal infection in the other part of the body. It can take the form of a tooth or itching in one area of the body which is not infected with the fungus. Dermatophytids can be considered as an allergic reaction to fungus.
Factors of Onychomycosis are in all pathogenous fungal states and include dermatophots, candida (yesost), and nodermatophane mold. Dermatophytes are usually responsible fungi for Onychomycosis in temperate western countries; Whereas Candida and nondermatophytic molds are often included in tropical and sub-tropical with warm and humid climate.
Trichophyton rubrum is the most common Dermatophyte involved in Onychomycosis. Other dermatophytes that may contain T. interdigitale, Epidermophyton floccosum, T. violaceum, Microsporum gypseum, T. tonsurans, and T. soudanense. A common old name that can still be reported by medical laboratories, Trichophyton mentagrophytes for T. interdigitale. Name T. Mentagrophytes are now restricted to the mouse’s favus skin infection agent; Although the fungus can spread from rats and their danders to humans, it usually infects the skin, in the nails.
Other factors include pathogens and candida and nondermatophytic mold, especially mold genus Scytalidium (name has been recently changed to Neoscytalidium), Scopulariopsis, and Aspergillus members. Candida species are mainly caused by unhappiness Onychomycosis in those whose hands are often immersed in water. Scytalidium mainly affects people in the tropics, though it continues even when they later go into the areas of temperate climatic conditions.
Other molds more generally affect people over 60 years of age, and their presence in the nail is weakening in the ability of nail to protect themselves against fungal invasions.
The Risk Factor
Due to aging blood circulation, prolonged exposure to fungus and nails that grow slowly and thicker, due to the increase in sensitivity to infection, the most common risk factor for Onychomycosis is the risk. Nail fungus affects men more often than women, and is associated with family history of this infection.
Other risk factors include heavy sweating, which are in humid or humid environments, wear psoriasis, socks and shoes, which obstruct ventilation and do not absorb sweat, barefoot is going on like swimming pool, Gym and shower room, such as athlete’s foot (tinea pedis), minor skin or nail injury, damaged nails, or other infections, and diabetes, problems of circulation, On issues and legs can cause lower peripheral temperature, or a weakened immune system.
Diagnosis is usually suspected on the basis of attendance and is confirmed by laboratory testing. Four main tests are a potassium hydroxide smear, culture, histology examination, and polymer chain reaction. Sample testing is usually nail scrapping or clippings. It is far from the nail as much as possible.
Nail plates with periodic acids appear biopsy periodic acid-Schiff stain or more useful than direct KOH examination. To recognize the reliability of nondermatophyte molds, many samples may be necessary.
Since the fungus is responsible for only half of the half dystrophies, the diagnosis of Onchyomycosis may be required by potassium hydroxide (KOH) preparation, culture or histology. Psoriasis, lichen planus, contact dermatitis, trauma, nail bed tumor and yellow nail syndrome can be mistakenly diagnosed as Onchyomycosis. A fungal etiology is impossible if all nails or toenails are horrific.
There are four classic types of onychomycosis:
• Distal Subungual Onychomycosis is the most common form of tinea unguium and is usually caused by Trichophyton rubrum, which attacks the nail bed and the bottom of the nail plate.
• White Superficial Onychomycosis (WSO) is caused by the fungal invasion of the surface layers of the nail plate to make “White Island” on the plate. It is responsible for about 10 percent of onychomycosis cases. In some cases, WSO is a misdiagnosis of “keratin granulation” which is not a fungus, but is the reaction of nail polish, which can cause nails to look chocolate white. To be confirmed a laboratory test should be done.
• Through the Proximal Subungual Onychomycosis proximal nail fold, there is a fungal entry of newly created nail plate. It is the least common form of tinea unguium in healthy people, but usually when the patient is immunocompromised.
• Candidal Onychomycosis is the invasion of men of the Candida species, usually in those people who often immerse their hands in water. This usually requires injuries prior to nail infection or trauma.
There are actually no fungal infections in many cases of suspected nail fungus, but only nail distortion.
Laboratory confirmation may be necessary to avoid mis-diagnosis in the form of nail bed tumors such as nail psoriasis, lichen planus, contact dermatitis, nail bed tumors such as melanoma, trauma, or yellow nail syndrome,
Other conditions which may appear similar to onychomycosis include: Psoriasis, normal aging, yellow nail syndrome, and chronic paronychia.
Most of the treatments are either antigenic or with either head or mouth. Avoid the use of antifungal therapy without transition (e.g., terbinafine) without confirmation due to the potential side effects of that treatment.
Topical agents include ciclopirox nail paints, amorolfine and efinaconazole. Some topical treatments need to be applied on a daily basis for a long time (at least 1 year). The occasional amorolfine is applied weekly. Topical Ciclopirox results in treatment in 6% to 9% of cases; Amorolfine can be more effective. Ciclopirox appears better than an agent alone when used with Terbinafine.
Medicines can be taken from the mouth include terbinafine (76% effective), itraconazole (60% effective) and fluconazole (48% effective). They share the characteristics that increase their effectiveness: quick access to nails and nails, and firmness in nails for months of medical shutdown. Ketoconazole is not recommended due to side effects due to side effects. Oral terbinafine is better tolerated than itraconazole. For surface white onychomycosis, systematic advice is given instead of topical antifungal therapy.
Historically, the treatment of Onychomycosis has been challenging. Oral administered griseofulvin (Grisactin, Gris-Peg) is available for many years, but its use is essential for a narrow spectrum, long courses of treatment and high relapse rates. Oral form of ketoconazole (Nizoral) is more effective but risk of hepatotoxicity.
Onychomycosis has long been treated with the preparation of topical antifungal. However, these agents are inconvenient to use, and the results are often disappointing. Treatment is more successful by using nail absorption in combination with topical therapy, but this approach can be time consuming, temporarily inefficient and painful.
U.S. The Food and Drug Administration (FDA) has labeled ciclopirox (Penlac) nail lacquer for the treatment of light on-medium Onychomycosis. T.Rubrum without Lunula’s involvement Although safe and relatively inexpensive, ciclopirox therapy is rarely effective.
In recent years, the results of treatment have improved significantly in patients with Onychomycosis, mainly due to the introduction of more effective oral antifung drugs, 8 current evidence supports the use of these new agents as part of individual treatment plans. Patient profiles, nail characteristics, infected organisms, potential drug toxicity and interaction, and helpful therapies.
Triazole and Alemlin antifungal drugs have replaced grisofulvin and ketokonazole in the form of first line medicines for the treatment of large amounts of ascomycomicosis. These agents offer short treatment courses, high treatment rates and fewer relapses. Of the 10 new drugs, terbinaafine (lamicil) and intraconazole (sporanox) are the most widely used, fluaconazole (diffloken) receives rapid acceptance. These medicines share the characteristics that increase their effectiveness: firmness in nails for quick access to nails and nails bedding, the closure of medicine and usually for months of good security profiles. Published studies measuring “myocological treatment” (negative KOH preparation or negative cultures) and “diagnostic treatment” (normal nail morphology) have demonstrated the effectiveness of all three drugs.