Fungal infection of the nails or onychomycosis is an infectious disease and a fairly common pathology.The prevalence of nail lesions in all countries of the world ranges from 18 to 45%.OnyChomyCoz is often found in elderly people, cancer patients and patients with diabetes, Kaposi's sarcoma and ichthyosis.
OnyChomyCoz is not just a cosmetic problem.It poses a serious threat to the human body, because it can lead to the development of the vital activity of fungi and hepatopathy, drug-related toxicity and even Lyell's syndrome.
Etiology and epidemiology
Derived points of onychomycosis are represented by three groups:
- Dermatophytes (up to 95%) - Trichophyton Rubrum (affects the nails of the feet and hands, as well as the skin, trichophytonmentaghites (affects the skin of the first and fifth fingers), epidermophytonfloxum (nails of the first and fifth fingers);
- Yeast fungi (up to 4%) - Candida SPP.(first affects the skin around the nails and then penetrates the nail plate itself);
- Molds (up to 1%) - Fusarium and Alternaria (most common in cases of immunodeficiency).
Isolated onychomycosis is rare;More often, simultaneous lesions of the skin of the legs, scalp and smooth skin are observed.
Infection occurs through household items: bathroom carpet, slippers, towels, manicure accessories;but also when visiting the bath, sauna or swimming pool.Men are more susceptible to this pathology than women.Mostly adults suffer from onychomycosis;Cases of nail mycosis among children are rare.
The risk group includes bath participants, military personnel, athletes, people who regularly visit baths and saunas, and miners.
The source of infection is the skin of the feet of an infected person;Sometimes entire families are affected.
Pathogenesis
OnyChomyCoz is the source of a fungal infection that can cause body sensitivity.In addition, mushrooms release substances that are toxic to the human body.
Predisposing factors for infection are injuries to the skin of the nails that occur when the toes and toes are squeezed by tight shoes;wet and hot environment created by some low-quality shoes made of unnatural materials;The presence of severe diseases, immunodeficiency conditions, old age.
Symptoms of the disease
Based on the differences in symptoms, four forms of onychomycosis are distinguished:
- Distal lateral (bottom) onychomycosisis the most common.The causative agents are Trichophyton red, Candida and very rarely, molds.With this type of lesion, the fungus in the nail bed spreads from the free edge of the nail and towards the matrix.In this case, due to hyperkeratosis, the nail plate gradually moves away from the bed and acquires a yellowish color.Thickening of the nail plate may occur and bacterial contamination varies from green to dirty brown.
- White superficial onychomycosismost often caused by Trichophyton Mentagrophytes, which causes the appearance of white spots on the surface of the nail plate;As the process progresses, these spots merge.This type of onychomycosis occurs in elderly patients with a bear deformity in which one leg covers the adjacent one.The nail plate becomes dystrophic, collapses and has a gray or brown color, but the matrix and epithelium of the bed are not affected, and there are no inflammatory phenomena from the skin.
- Proximal Subungual OnychomycosisThe pathogen, the rarest type of red trichophyton, penetrates through the nail plate or periungual layer, then spreads locally and reaches the matrix and distal parts of the nail plate.As a result, a wide detachment of the nail plate is observed.With secondary bacterial contamination, the nail plate changes color.
- Common dystrophic onychomycosisIt occurs in distal lateral or less often, proximal subungual, as well as in chronic subcutaneous candidiasis.This form affects the complete destruction of the entire nail;The nail layers are either absent or pathologically thickened, a normal nail plate cannot form.
All onychomycosis should be distinguished from psoriasis, eczema, lichen planus and other skin diseases.To confirm the diagnosis, it is necessary to carry out a microscope of the pathological material from the lesion and culture of the pathogen in a special identity media.
Treatment of onychomycosis
When prescribing treatment for a patient with OnyChomyCozu, a number of factors should be taken into account: the type of pathogen, the spread of the process, the patient's general condition and financial capabilities.
- Local agents are often used when there are no more than 3 nails, as well as in patients with types of antimasots, types of contigotics.The most effective topical preparations include creams and varnishes.They are often combined to achieve a faster therapeutic effect.High concentration of active substances in preparations;They work effectively on the surface of the nail plate, but cannot constantly penetrate the nail bed, where the most persistent fungi are located.In such cases, the affected nail plate is removed either surgically or with the help of special chemicals - keratolytics and local treatment is continued.This method is inconvenient only because of the length of the process, because it requires careful adherence to the treatment regimen while a healthy nail plate grows.In this case, ointments should be applied daily, and varnishes only once a week.
- Systemic therapy is more effective and reliable in the treatment of onychomycosis;It is used when local treatment fails.Indications for the appointment of systemic drugs late stages of distal lateral and proximal subaguchomycosis, as well as general onychomycosis.
The choice of drugs for systemic treatment should be justified by taking into account the pharmacokinetics, spectrum of action and antifungal activity of each drug.We must not forget that any drug can produce a declared therapeutic effect if it is prescribed adequately.