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Abstract: Patient Auntie Li, 53, had been suffering from onychomycosis for many years. She had foot odor before and did not pay much attention to it, but after a few months, her toenails began to become brittle and yellow, sometimes with powdery flakes, and at first it was one toenail, but over time other toenails were infected, so she came to the hospital. She was diagnosed with onychomycosis combined with tinea pedis, and was cured of onychomycosis after taking oral antifungal medication and applying topical drops and creams.
Basic information】Female, 53 years old
Disease Type】Tinea capitis combined with onychomycosis
Hospital】Maanshan Seventeen Ye Hospital
Date of Consultation】February 2022
Treatment plan】Medication (Itraconazole capsule + sertaconazole nitrate cream + compound tincture of hibiscus)
Treatment Period】4 months of outpatient treatment
Results】Cured nail fungus, restored luster to toenails, negative nail dander fungal microscopy
I. Initial consultation
The patient, Auntie Li, came to the hospital and said that a few years ago, blisters appeared on her feet and it was itchy, so she didn’t pay much attention to it and often used her hands to pick at it. After coming to the hospital, a nail dander fungal microscopy was performed, and spores and mycelium were seen, and she was diagnosed with onychomycosis combined with tinea pedis.
II. Treatment history
The patient’s liver function was then checked and the results were normal, so he was given oral antifungal medication Itraconazole capsules and topical medication sertaconazole nitrate cream and compound tincture of hibiscus. After the first month of treatment, there was no obvious effect, but the blisters and flaking symptoms on the feet subsided, and later 2-3 months when new toenails grew out, basically normal toenails, the lesion toenails gradually fell off. In the fourth month, the toenail regained its luster and the fungal microscopic examination of the nail dander was negative. The patient’s liver function was normal on all four follow-up examinations, and no liver function damage was caused. The patient was instructed to remove the thick nail flakes with a file before applying the drug topically, which would improve the efficacy.
III. Treatment effect
Itraconazole capsules are commonly used as antifungal drugs and have good antibacterial effects on dermatophytes such as onychomycosis and tinea pedis, but they also have side effects and some patients may have elevated liver enzymes after taking them. Therefore liver function needs to be checked before and after medication. Fortunately, the liver function check during the patient’s treatment did not result in elevated liver enzymes. After 4 months of oral itraconazole capsules with sertaconazole nitrate cream and topical tincture of compound tulip, the patient’s toenails regained their luster, the nail dander fungal microscopy was negative, and the symptoms of blistering and peeling on the feet subsided.
IV. Notes
I am glad that after active treatment, the patient was cured of the disease. Nail fungus treatment usually takes 3-4 months, and it is important to stick to using persistent treatment so that the nail fungus can be cured. Since onychomycosis is contagious, it is important not to mix shoes and socks with family members and to wash and dry shoes and socks regularly. When trimming toenails, the toenail cutter needs to be disinfected to prevent infection to other toenails and also to prevent injuries to the toenails, as fungal infections can easily occur secondary to trauma to the toenails. In addition, oral antifungal drugs may cause liver enzymes to rise, so be sure to check liver function before and after using the drug.
V. Personal insight
Nail fungus is contagious and can infect not only yourself but also your family. If left untreated, it may cause bacterial infections of the lower extremities, such as nail fungus and dermatitis, and other skin problems. Nail fungus is mainly due to the spread of fungal infection, so it is important to treat it promptly when you have nail fungus. The treatment cycle for onychomycosis takes 3-4 months, and it must be treated consistently to be cured. Oral antifungal medications may have an effect on liver function, so it is important to follow up with your doctor and have regular liver function tests.