Onychomycosis is a fungal infection that attacks the human nail plate.The causative agent of the disease is pathogenic and opportunistic fungi.The term onychomycosis was introduced in 1854, but the disease in Russia was mentioned for the first time PIMatcherskim in 1861 in the thesis. Currently, the pathogenesis of the disease is rapidly going up, due to a quantitative increase in the factors that affect their development.
onychomycosis nail , like athlete's foot, is a common human mycotic disease.By the force of incidence of onychomycosis is different in countries with different climate conditions.For example, onychomycosis in Spain diagnosed in 1.7% of the population (0.8% of men, 1.8% women), while in Finland, surveyed 800 people, found 8.4% of cases (4.3% of women and 13%men) in Russia detected in 5% of the people given disease.Often, the reason why go to the doctor, speaking dissatisfaction with the nail plate, and it is their appearance that affects the decline in the qua
There are 50 species of opportunistic and pathogenic fungi that cause strong damage nail plates.However, a dominant position at the dermatophytes.Their number reaches 90%.These include antropofilnymi dermatomitsetami: Tr.Tonsurans, Tr.mentagrophytes, Tr.Mentagrophytes, Epidermophyton floccosum, Trichophyton rubrum, Tr.violaceum, and zoofilnye Tr.verrucosum.In rare cases, the infection of the nail plate fungi Microsporum.
Another cause onychomycosis may make yeast-like fungi (Malassezia, Candida).Candida species are also a frequent cause of onychomycosis hands of women, who are engaged in housework.
source of infection onychomycosis is primarily a patient, as well as subjects infected pathogens.It is established that every person throughout life repeatedly in contact with the fungi of onychomycosis, but the disease does not develop at all.
infection onychomycosis nail possible during visits to the baths, saunas and swimming pools.Hazards include benches, railings, paths, carpets, which are covered with flakes of skin from pathogenic fungi.Often, the transfer is carried out intra-nail onychomycosis and in this case, the subject of infection are the common slippers, washcloths, towels, and bathrooms.The scales have the ability to fall off during combing infected skin.
onychomycosis nail capable of provoking and other factors.Such as insufficient blood supply to the extremities, diabetes, HIV, immunodeficiency states.
onychomycosis in children is found infrequently and is usually caused by underlying medical conditions.Due to the accelerated rate during the growth of the nail plate, the children are very low incidence of onychomycosis.
onychomycosis in children has the following features: the surface of the nail has a rough surface, the configuration of the nail is maintained, and the defeat of the plate is more often observed at the distal edge, and is rarely observed subungual hyperkeratosis.Terbinafine is approved for use in the treatment of onychomycosis in children.
much higher incidence in the group of children born to HIV - infected people and to get them children with Down syndrome.
Older people are often exposed to the disease, as it is associated with endocrine changes and physiological properties of the skin and its appendages.Pathogenesis of onychomycosis a vascular pathology of the elderly and related diseases: Raynaud's syndrome, venous insufficiency, lymphedema, diabetes, injuries, general weakness, skin maceration, hyperhidrosis.
onychomycosis feet often acts of family infection.The growing prevalence of the disease is due to refusal of medical treatment and as a result, patients suffer from toenail onychomycosis years.
Outwardly manifested loosening onychomycosis, thickened and brittle nails.This affected nails fade, become deformed, yellow, thicken and crumble further.Fungal infection of the years takes severe, creating not only a cosmetic problem, but a problem with the selection of shoes.Patients experience discomfort when walking, pain, limitation in movement.Along with this falls self-esteem, decreased quality of life.
diagnosis of onychomycosis includes mycological assessment study, as well as the availability of a particular clinical picture.Note the following primary criteria: white-yellow, and orange-brown stripes or spots.Secondary criteria: subungual hyperkeratosis, onycholysis, thickening of the nail plate.
There is a classification of onychomycosis, taking into account the thickness of the affected nail.AMArievich identified the following types of onychomycosis: normotroficheskie first, second and third hypertrophic atrophic.
normotroficheskie type is characterized by the preservation of the thickness and configuration of the nail, the only change is the color and transparency.
Hypertrophic type is marked thickening of the nail plate thickening due to subungual hyperkeratosis.
Atrophic type is characterized by thinning of the nail plate.
In modern foreign onychomycosis classification are the following: a surface white, the following type - distal subungual onychomycosis, followed proximal subungual onychomycosis and final type - a total dystrophic onychomycosis.
treatment of onychomycosis possible local when an antifungal medication directly applied to the infected nail, as well as a system in which the drug is prescribed inside, and through the blood penetrates the nail plate.
in diseases caused by dermatophytes, appointed common antifungal drugs.Which include Orungal, griseofulvin, Nizoral, Lamisil.
If onychomycosis caused by yeast and molds, the same treatment as described above (except Griseofulvin, this drug is not assigned).
- Nizoral, its daily dose of 200 mg duration of 4 months to improve the condition and not yet fully grown transparent nail plate.
- Lamisil, his daily rate of 250 mg, the duration of 3 months, and in the absence of results for up to 6 months.
- Orungal, his daily rate of 100 mg lasting from 2 to 6 months.
onychomycosis treated pathogenic agents, which include immune-boosting agents, adaptogens, angioprotectors, vitamins, adaptogens.
treatment of onychomycosis nail antifungal agents must necessarily go together with external therapy, which consists of two stages.
First, the removal of the infected nail, or part thereof as necessary (surgical or conservative treatment).
Second includes the treatment of the nail bed and the nail plate grows.To do this twice a day in the days techeniepyati Andriasian liquid applied to the nail bed.
liquid is Andriasian (glycerol - 20.0% acetic acid, 40 - 40.0 and ethyl alcohol - 50.0).Following five days cause fluid twice daily №2, which composition comprises (10.0 salicylic acid, lactic acid, 10.0, 50.0 collodion, resorcinol 2.5).
sixth day includes a bandage with 5% salicylic ointment.The seventh day is moderately hot soda bath, and after cleaning.Further, the treatment is repeated until the final nail regrowth.
Reviews patients about the treatment of onychomycosis of the nails in most cases, say that often enough local treatment.And the effect is achieved at the surface of white and distal-lateral form of the disease when infected with 1/3 nail.
How else to treat onychomycosis?
nail in onychomycosis treatment effectively implement such a tool as a 20% solution salitsilovo- benzoic acid Dimexidum.This tool is applied on the nail of one drop of up to two times a day and be sure to clean up after.
Preparations of onychomycosis include a variety of fungicidal ointment (Kanesten, 5% salicylic ointment, liniment, miconazole, griseofulvin, Lac Batrafen, Grimeksal, ointments mikospor, Nizoral, Lac Loceryl, travogen, Lamisil, etc..).
Terbinafine or Terbinoks has also become urgent today in the treatment of onychomycosis.He has a good antifungal effect, and studies have shown that the drug is well tolerated by all segments of the population.
criteria by which to judge of recovery are: the disappearance of clinical symptoms, as well as complete regrowth of the nail plate and mandatory triple negative tests for mushrooms.These analyzes are carried out after the end of treatment and then every two months.It is also important to carry out follow-up every three months.It is important to remember the incredible vitality of the fungus in the environment and the development of resistance to substances that are part of antifungal drugs.Therefore, if the fungus is not recovered, then the re-infection treatment using other drugs with distinctive mechanism of its action.