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Fungal lesion of the nail plates

Onychomycosis is a fungal lesion of the nails. The disease occurs in 5-10% of the population and accounts to about 30% among other nail lesions.

Causes of onychomycosis

Onychomycosis can be caused by household articles disseminated with pathogenic and opportunistic parasites. These articles include rugs in the bathroom, wash-rags, manicure accessories, footwear. People may be infected when visiting a swimming-pool, baths, sauna, sports hall or while taking a shower.

Onychomycosis can occur at any age, but it is more prevalent among adults. Though, during the last 10 years, the incidence of onychomycosis increased among children and adolescents.

Various traumas, broken feet and wrists and disturbed blood circulation in the limbs (varicose veins, Raynauld’s disease and others) can contribute to the development of onychomycosis. Patients suffering from severe somatic endocrine diseases and immune disturbances are at a greater risk of getting a disease, with the course of the disease being more severe. The incidence of onychomycosis is 3-fold higher in diabetic patients as compared with other people.

Types and symptoms of onycomycosis

There are 3 main types of onycomycosis: normotrophic, hypertrophic and atrophic.

            In normotrophic onycomycosis, the nail preserves its normal thickness and natural shine. Only the color of the nail plates undergoes changes due to the appearance of streaks and spots on the lateral areas.

In hypertrophic onycomycosis, the treatment is difficult because of progressing hyperkeratosis that leads to deformation and partial destruction of the nails, as well as pain at walking. The nails become dull and thick.

When the patient has atrophic onycomycosis, the damaged part of the nail plate acquires brownish-grey color with consequent atrophy and rejection from its matrix.

The diagnosis is made by visual examination of the nail plates.

Prophylaxis

Prophylaxis of onycomycosis can be divided into public and personal. Public prophylaxis includes the provision of hygiene in public places: baths, saunas, swimming-pools, and shower-rooms; their regular cleaning and disinfection. It also involves prophylactic medical check-up of the service staff, people often visiting the swimming-pools, as well as those from the risk groups (sportsmen, some working specialties, military men).

Personal prophylaxis includes:

  • the use of individual footwear;
  • observance of hygiene of the feet skin;
  • prophylactic use of local antifungal remedies when visiting swimming-pools and public shower-rooms regularly;
  • timely treatment of mycotic lesions of the feet;
  • disinfection of footwear or replacing it by new ones in the case when fungal disease of the feet or nails has been detected;
  • increase in the body resistance.

L.V. Kalinovskaya,  doctor-dermatologist