TINEA UNGUIUM – Risk Factors, Clinical Manifestations, Diagnostic Evaluations and Management 

TINEA UNGUIUM – Risk Factors, Clinical Manifestations, Diagnostic Evaluations and Management

Fungal nail infections, or onychomycosis, is a condition in which a fungal or yeast infection occurs in the nail plate that causes the nails to be thick and brittle. It is caused by Trichophyton species or candida albicans

RISK FACTORS

The following are instances that either promote infection with fungi or encourage growth of fungi:


  • Tight footwear promotes crowding of the toes keeps the toes warm and moist
  • Diminished blood circulation
  • More years of exposure to fungi
  • Perspiring heavily
  • Working in a humid or moist environment
  • Having the skin condition psoriasis
  • Wearing socks and shoes that hinder ventilation and don’t absorb perspiration
  • Having athlete’s foot (tinea pedis)
  • Having a minor skin or nail injury, a damaged nail, or another infection
  • Exercise can cause repeated minor trauma to the hyponychium allowing fungi to invade
  • Communal showers can expose the feet to fungi
  • AIDS and diabetes


 

CLINICAL MANIFESTATIONS


  • Usually, there are no symptoms. It is often a cosmetic problem
  • Occasionally, it can cause pain or discomfort
  • The nail usually a brittle, thickened, dull, and easily breakable
  • Debris accumulates under nail plate and nail plate separates
  • Sometimes, surrounding skin can become infected and cause cellulitis (inflammation)


DIAGNOSTIC EVALUATIONS


  • Examination – doctor usually easily recognizes the typical appearance of the infected nail
  • The doctor may also scrape the nail and examine it under the microscope
  • Sometimes, a culture of the nail may be needed to make the diagnosis


 

MANAGEMENT

Onychomycosis is difficult to treat because one has to take medicines for a very long time, and often the problem comes back after stopping the medication

 


  1. Oral medications: to treat nail fungus, doctor may prescribe an oral antifungal medication. Studies have shown the most effective treatments to be terbinafine and itraconazole (sporanox).
  2. Antifungal Lacquer: if you have a mild to moderate infection of nail fungus, doctor may prefer to prescribe an antifungal nail polish called ciclopirox (penlac)
  3. Topical medications: doctor may also opt for other topical antifungal medications. Advised to use these creams with an over-the-counter lotion containing urea to help speed up absorption
  4. Surgery: if nail infection is severe or extremely painful, doctor may suggest removing nail. A new nail will usually grow in its place, though  it will come in slowly and may take as long as a year to grow back completely.


 

PREVENTION


To help prevent nail fungus and reduce recurrent infections, practice - good hand and foot hygiene


  • Keep nails short, dry and clean
  • Keep the skin dry. Moist skin encourages fungal infections
  • Dry all areas of the skin after a bath or after heavy sweating
  • Wear appropriate socks and change socks frequently
  • Wear loose fitting clothing
  • Use an antifungal spray or powder
  • Wear rubber gloves
  • Don’t trim or pick at the skin around nails
  • Don’t go barefoot in public places
  • Choose a reputable manicure and pedicure salon
  • Give up nail polish and artificial nails
  • Wash hands after touching an infected nail


 

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TINEA UNGUIUM – Risk Factors, Clinical Manifestations, Diagnostic Evaluations and Management