Onychomycosis
Fungal infections are often uncomfortable conditions and they can have both physical and psychological consequences to the individual. Onychomycosis (OM) is one of the fungal diseases that results from a dermatophytic invasion of the nails. Fortunately, in the last few years, new oral treatment has successfully lowered the incidence of recurrence and side effects (Tosti & Piraccini, 1996).
What is Onychomicosis?
OM can be referred to as a localized infection of the nail, caused by a pathogenic fungi. It is characterized by discoloration and thickening of the nail, and thus, the nails are often thick, yellow, or brittle. OM can cause pain and discomfort, but it is mainly a receptacle for infection (Mooney, 1993).
OM includes a subgroup of nail infections with dermatophytic fungi known as tinea unguium. The three clinial types of tinea unguium are: distal subungual OM, proximal subungual OM, and superficial white OM (Morris, Gurevitch, & Edwards, 1992).
Distal subungual OM features thickening and opacification of the nail plate along the distal borders(Hay, 1986). In proximal subungual OM, a white spot appears beneath the proximal nail fold and may extend distally to involve the deeper layers of the nail. The surface is the initial site of invasion in superficial white OM. The surface becomes roughened and the nail plate crumbles easily, acquiring a yellow color (Arnold, Odom, & James, 1990).
Etiology
Twenty percent of all nail disease can be attributed to fungi (Morris, Gurevitch, & Edwards, 1992). The main micro-organism that causes OM is a dermatophyte: Trichophyton rubrum, Trichophyton mentagrophyte, Trichophyton interdigit...
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Cyanosis is a disorder which causes “bluish discoloration” to the skin, specifically around the mucus membranes or nail beds. There are two types of Cyanosis disorders, depending on where the cyanotic discoloration is occurring. For example, if the cyanotic discoloration is occurring around the nasal or oral tissue membranes, this type of cyanosis would be described as Central Cyanosis. In the same matter, if the bluish discoloration is occurring in extremities such as toes or fingers, it would be called peripheral cyanosis (acrocyanosis). Both of these types of cyanosis disorders derive from problems in hemoglobin oxygen intake, however the body reacts differently towards central cyanosis as opposed to peripheral cyanosis.
It gradually spreads deeper below the nail until the fungus affects the whole nail including the nail bed. This is why new nail growth is infected.
Repeat the process in order to make the surface even. Ensure that no discrimination can be made between the natural nail and the artificial one.
This condition is uncommon in children, yet having this condition can create psychological distress and predisposes the child to recurrent cutaneous fungal infections. The treatment for this diagnosis is similar to Tinea Capitis in the fact that it includes administering oral antifungal medications for an extensive period of time along with topical applicatons. The term used for fungal infections of the nail is known as onychomycosis. The dermatophte responsible for this is named Trichophyton rubrum (T. rubrum). This organism usually invades through the plantar skin lateral to the nail, then continues to the underside of the nail. This causes the child's inflammatory response to react resulting in thickening of the nail plate, formation of subungual debris, and separation of the nail from the nail bed. Then it spreads and can become so severe that it causes permanent scarring of the nail matrix. Signs and symptoms of this condition are distal and lateral separation of the nail plate from the nail bed (onycholysis) and accumulation of keratin debris under the nail (subungual hyperkeratosis), and yellowish nail discoloration with thickening of the nail. This is usually diagnosed through laboratory tests by clipping the nail, fungal cultures, and microscopic potassium hydroxide
Hochadel, M. (2014). Mosby's Drug Reference for Health Care Professionals (fourth edition ed.). : Elsevier.
Normally ciclopirox nail lacquer is well tolerated. Some cases has been reported about this nail lacquer that cause light reddening or scaling skin when the nail lacquer come into contact with the skin that adjacent to the nail (Gupta et.al, 2000). The most frequent adverse effect of the usage ciclopirox nail lacquer can be seen in the Sibissi et.al (2010) researc that caused local and dermalogical effects and it was rarely for the severe condition that require for the discontinuation of the medication. Another side effects that has been informed by Bhapkar et.al (2013) is that it do caused nail disorder like ingrown toenail, irritation, discolouration and changes in shape. The most frequent adverse effects are periungal erythema and erythema of the proximal nail fold.
Psoriasis can appear on any part of the body. It is more likely to develop on the scalp, elbows, hands, groin, knees, legs and feet. It can also cause thick, discolored finger and toe nails. Psoriasis is known to be hereditary, meaning that the gene that causes the disease ca...
Suzanne is a 56-year-old female who suffers from acrodermatitis continia (L40.2), along with anxiety, arthritis, asthma and hypercholesterolemia. Her symptoms include painful, thickened, discolored and moderate in severity, dystrophic nails and cracked fingertips. Suzanne has tried and failed various treatments including olux, clobetasol and triamcinolone, which have provided her with little to no relief, despite months of treatment. Acrodermatitis continua of Hallopeau (ACH) is a rare inflammatory disease characterised by pustular eruptions beginning in the tips of fingers and toes (digits). The pustules may vary in extent over a chronic, recurrent course. Pustulation of the nail bed and its growth site (matrix) can result in onychodystrophy
There may be small pits that are pinpoint depression or white spots, appearing on the nails. Nail psoriasis can be larger brown- yellowish separation of the nail beds usually called ‘oil spots.’
Fungal infections are either opportunistic or endemic ubiquitous fungi that exist freely in the environment cause endemic fungal infections. On the other hand, opportunistic fungal infections only cause disease when the immune system degrades [1]. Opportunistic fungi are commensal with the host and a very low intrinsic virulence to cause until the immunity is altered. Some of these include: Candida species, Aspergillus species, pneumocystic jirovecii and Cyptococcus neoformans. These disseminate diseases such as: oral candidiasis (oral thrush), genito-urinary disease and ocular or sinus infections which may spread to involve the Central Nervous system [2]. Opportunistic fungal infections are mainly immunocompromised individuals such as: those with HIV, extensive surgery, haematological disorders, and those who have corticosteroids, cytotoxic and suppressive chemotherapy. As a result, their neutrophils drop to abnormal counts, a conditioning know as neutropenia. This state predisposes these patients to many opportunistic fungal infections such as: candidiasis, aspergillosis, cryptococcosis and pneumocystis among others [3].
If you develop ringworm, see your doctor, who will likely prescribe an antifungal cream to treat the
Toenail fungus or onychomycosis, happens when a fungus enters the nail via a crack in the nail. Nail infections are very contagious and are commonly spread in swimming polls, locker rooms and spa environments because they are warm wets places that host bacteria and let it flourish. Although nail fungus can occur in the fingernails, the toenails are much more susceptible. Toenail fungus is easy to pin point because the toenails are usually