Modern aspects of diagnosis and treatment of onychomycosis

If a person's defenses are weakened, immunity is lowered, he eats poorly and has little rest, then the fungus can join the rest of his existing problems. Such patients can become infected from a patient with onychomycosis of the feet through shoes, after walking barefoot on the floor in showers and saunas. Who is more likely to get onychomycosis? What are the aspects of diagnosis and treatment of nail fungus, read more on estet-portal.com.

Clinical picture and varieties of onychomycosis

Nail fungus most often affects housewives. The disease also affects people working in enterprises where vegetables and fruits are preserved, in confectionery industries. Previously, onychomycosis was considered an occupational disease. Also at risk are women who work as waitresses, laundresses, dishwashers and food vendors.

The main causative agent of paronychia and onychomycosis – fungus Candida albicans, the second most common fungus - Candida parapsilosis.

Clinical forms of onychomycosis:

• candidal paronychia;
• candidal onychomycosis.

Symptoms and clinical features of candidal paronychia

Candidal paronychia has a wavy chronic course, inflammatory reactions are not very pronounced. Pain is mild or absent.

When the disease begins, the skin around the nail fold turns red, becomes thinner, and its pattern is smoothed out. There is a swollen roller with undermined or rounded edges. The skin of the nail disappears. When pressed on it, a yellow-white purulent discharge may appear. If the nail skin is absent, this is a sign of the chronic course of onychomycosis.

By changing the surface of the nail plate, one can judge the duration and course of paronychia. Transverse or parallel stripes and elevations appear, which are called Bo's lines.

Discoloration of the nail plate is caused by bacteria (Pseudomonas spp.). In bacterial paronychia, there is purulent discharge and tenderness.

Symptoms and features of the course of candidal onychomycosis

If the cause of the nail fungus is Candida albicans, the proximal form of candidiasis usually occurs, and the distal form of candidiasis occurs less often.

The proximal form of onychomycosis is nothing more than a consequence of paronychia. At the proximal edge, the nail plate becomes soft, bends when pressed, exfoliates, a positive symptom of fluctuation is observed.

The distal form is characterized by the color of the nail plate at the distal edge, which is unusual for the nail. Later, this plate acquires friability, fragility, due to hyperkeratosis becomes elevated. This form of candidal onychomycosis is more often observed in people who suffer from circulatory disorders, Raynaud's syndrome and other skin diseases, notes estet-portal.com .. Typical note is the presence of light white spots that can be seen under the nail plate.

Diagnosis of onychomycosis: culture and microbiology

Culture and microbiological studies are used for diagnosis. Microscopy is performed using the KOH-test, during which the substrate is treated with a 10-30% solution of caustic potassium to dissolve keratin. The next step is to study under a light microscope. In the course of this study, it is only possible to clarify or refute a fungal infection of the nail. The type of fungus is not determined by this method.

The cultural method for detecting onychomycosis is to inoculate the material on Sabouraud's medium. After the culture has matured, it is studied under a microscope and the type of fungus or bacteria is determined. This makes it possible to determine the treatment of severe forms of onychomycosis that are not amenable to standard therapy. The method is not more than 60% sensitive, so it is not used often.

Recently, the issue of developing DNA studies of fungal infections of hair, nails and skin has become topical. The first studies that were carried out showed 95% sensitivity of this method.

When making a diagnosis, it is worth considering that some diseases are similar in clinical picture to fungal nail diseases: for example, psoriasis, onychodystrophy, keratoderma and lichen planus.

Modern approach to the treatment of onychomycosis

Changes in the appearance of the nail plate are an indication for initiating systemic treatment. These changes are observed in the form of transverse furrows, which mean a chronic relapsing course of a fungal infection of the nail, regardless of the presence of an acute process of onychomycosis.

When combined with skin candidiasis and paronychia, it is also advisable to use systemic treatment, since topical treatment most likely will not bring the desired effect. Local treatment is prescribed during an exacerbation of paronychia. For better penetration of antimycotics, it is necessary to soften the affected parts of the nail well, and then remove them. For this purpose, a 3% solution of boric acid, a solution of potassium permanganate, hot baths with sodium bicarbonate are used.

After these procedures, any antifungal agent is prescribed. It is advisable to conduct a short course of treatment with systemic antimycotics.

In the acute stage of fungal infection, it is recommended to lubricate the nail folds with antiseptics up to 3 times a day for 2-3 weeks.

Treatment of such chronic sluggish diseases as onychomycosis is long and complicated. It is much easier for patients to take care of themselves and prevent fungal diseases. You just need to monitor your health and lifestyle, have personal slippers in pools, baths and saunas. And those patients who already suffer from onychomycosis should always cut their nails short, and also thoroughly wipe their hands and feet after water procedures so that they are dry. By telling such simple things to patients about onychomycosis, you will improve their quality of life.