Nail Fungus

Nail infection of fungus is known as Onychomycosis. Fungus can infect both toenails and fingernails. Infection may manifest as a little white spot or yellow spot on the nail ignoring the condition may lead to the spread of the fungus deep into the nails which may further discolor the nails and may lead to thickening of nails and also abnormal growth of nails which may lead to uneven nails. If the condition deteriorated then it may lead to the painful and cosmetically unsightly nails. The infection commonly affects the persons who are regularly and frequently exposed to warm and humid environment. Even there are places at which individuals are more susceptible to get fungal infection like near swimming pools, locker rooms, shower floors and in the shoes which sweat. It is difficult to treat a nail fungus but there are medications available and regular use can eradicate the fungus in due course of time.

Causes

• The infection of the nails can be mainly caused by the following organisms
• Dermatophytes group of fungus
• Yeast or Candida
• Some non Dermatophytes like Molds

Type of infection

Depending upon the pattern in which the nails are affected the fungal infections can be classified into various categories. Trichophyton Rubrum is a Dermatophyte which is most commonly encountered in the nail infections.

Distal Subungual Onychomycosis

When an infection starts from the corner and spreads towards the centre of the nail it is known as Distal Subungual Onychomycosis. It is the most common variety of the nail fungus infection. It usually involves greater toe of the foot but can occur in any nail. It raises the nail up and discolors it.

Proximal Subungual Onychomycosis

When a fungal infection manifests at the base of the nail then it is referred to as Proximal Subungual Onychomycosis. It is less commonly encountered variety of nail fungus. It starts at the base of the nail plate and then slowly spreads towards the tip. It is always found in the persons who are immunocompromised.

Yeast or Candida Onychomycosis

Candida commonly affects the nails of the fingers and the patients generally suffer from the chronic Paronychia. The patients are commonly found orally infected with Candida.

Symptoms

• Nails are thickened
• Nails are discolored
• Nails may be brown, black or discolored
• Nails show unusual and uneven growth
• Nails are distorted and rugged
• Nails may be brittle to minor injuries
• Nails lack lusture and may be uneven
• There may be some deposition under the nails of dead tissues which may lead to dark color of the nails

Risk Factors

• Diabetes
• Moist Environment
• Lack of proper ventilation inside shoes
• Excessive sweating
• Abnormal immune response
• Family history of nail fungus

Investigations and Diagnosis

Using KOH staining fungal infection can easily be established and even the infecting organism can be identified and treatment can be started on that line. Samples can be taken from the nail debris and the same is fixed on the slide and the staining is done using KOH and fungi can easily be identified by the professionals

Treatment and Drugs

• Oral medications like griseofulvin, terbinafine, itraconazole and fluconazloe are routinely prescribed depending on case to case basis but are generally not very effective.
• Topical antifungal creams and lotions are advised for long durations like several months. Combined therapies are generally effective and may eradicate the fungus but the chances of relapse are quiet fair.