What kind of disease is nail fungus?
Nail fungus is an infection of the peripheral and proximal nail folds of the finger (toe) nail. Predisposing factors include excessive nail trimming, nail biting and finger sucking, diabetes and prolonged exposure of the fingers and toes to moisture, or prolonged medical application of inhibitors of epidermal growth factors. After a minor injury to the perinail crease, bacteria can remain in the gap between the nail and the crease and infect the perinail through a tiny wound.
Nail fungus can be acute or chronic.
Acute onychomycosis is characterized by pain and erythema around the nail, which can be followed by abscesses around the nail. The organisms that trigger nail infections are often skin flora, such as Staphylococcus aureus or Streptococcus pyogenes. In cases where the fingers and toes may be exposed to the oral environment (e.g., finger sucking), the causative organisms are both skin and oral resident colonies, such as Candida and anaerobic bacteria can be the causative organisms. In patients with eczema or psoriasis, chronic nail fungus is often secondary to minor trauma due to poor peripheral circulation. In addition, some of the drugs used to treat psoriasis that alter keratin metabolism, such as Avelox, may also have side effects that predispose to onychomycosis.
Diseases that need to be differentiated from onychomycosis include.
1, nail fungus: caused by fungal infection of the nail plate, the nail plate is loose and brittle, and the perinail folds are usually not involved.
2. Herpes simplex whitlow: appears after exposure to herpes simplex virus with large blisters, pustules and severe edema, with evidence of herpes simplex virus infection. If Tzanck (multinucleated giant cells) is visible on herpes fluid smear, HSV-IgM is positive.
3, pustular psoriasis: there may be similar manifestations of nail fungus, but the nail plate will be significantly altered and there are mostly psoriatic lesions in other areas.
4, Pseudomonas aeruginosa infected nail: often secondary to chronic nail fungus. In particular, frequent immersion in water is an important predisposing factor.
Based on the swelling around the finger (toe) nail and the obvious tenderness of the perinail crease, nail fungus can be diagnosed. Chronic nail fungus also has a retraction of the perinail crease, loss of the protective membrane, and a dystrophy-like nail plate.
Treatment of nail fungus should be aggressive to relieve symptoms as soon as possible and to avoid comorbidities such as osteomyelitis and cellulitis. Treatment includes the systematic application of antibiotics, and topical antibiotic ointment can be applied after local warm water washing and soaking, which can be selected for coccidial infections such as compound polymyxin ointment or mupirocin ointment.
Acute nail infection combined with abscess formation requires incision and drainage, and when the abscess is superficial, pus can also be aspirated with a large needle.
For babies with finger-sucking habits, the antibacterial spectrum should also take into account anaerobic bacteria and Candida. Chronic nail infections also need to be treated in conjunction with eczema.
In the course of treatment, the following issues must be noted on a daily basis.
1. keeping hands and feet dry and warm.
2. avoiding prolonged play in wet or water
3. careful cleaning of the fingers (toes).
4. Do not allow the skin to dry excessively.
5. apply hand cream daily to protect the hands and feet.
Complete removal of nail infection usually takes several months, and for susceptible individuals, it still tends to recur after the presence of predisposing factors.