Epidemiology
The risk of having an infection by a dermatophyte in the life of a person between 10 and 20% and is one of the most common forms of onychomycosis. The nails of the feet are more affected than those of the hands , affecting adults more often than children.The pedicure inadequate, with scissors and contaminated instruments can also develop fungi, so it is advisable to nail scissors is for the exclusive use of one person. Other risk factors include sports, diabetes , poor circulation in the limbs and improper use of shoes (such as using those without ventilation).
Usually it does not present with symptoms , being a problem cosmetic mainly to show nails of whitish or yellowish coloration , broken, fragile and deformed. As the infection progresses , the separation of the nail plate from the nail bed is seen. Occasionally it may be accompanied by pain, or discomfort, and it is rarely seen cellulitis of the neighboring skin . The distal end of the nail is the one that is affected much more frequently, the less frequently it can start at the proximal or lateral end.
DIAGNOSIS
The combination of medical history , physical examination and laboratory diagnosis are critical for correct diagnosis . The onychomycosis caused by other organisms are very similar in their clinical presentation. Direct examination with 30% KOH and mycological culture (Sabouraud agar) will confirm the correct dermatophytosis , if one exists. Sampling is simple, examining scrapes of the nail or debridement of the injured tissue below or around the nail. Cleaning the sampling area with 70 percent alcohol minimizes contamination of environmental agents and normal flora. Dermatophytes in Tinea unguium are difficult to grow and about 50% of the samples do not grow in the culture media. It is also important to take into account that these fungi grow slowly and can take from 14 to 28 days in which the culture Be positive.
Treatment
Treatment of onychomycosis is a challenge because the infection is inserted inside the nail and isdifficult to reach, complete elimination of symptoms is slow and can take a year or more. The treatment is divided into two routes: topical and systemic route. The topica route includes nail, cream, talc and laser solutions. The systemic route, with antifungal drugs such as ketaconazole, itraconazole, terbinafine.
SOURCE: WIKIPEDIA.COM