Onyokomycosis(Nail fungi) damage to the mushroom infection of the nail plate and surrounding devices: nail rolls, matrix (chicken of the nail) and nail bed.Deformation of nails, a change in colors, nails turn white or yellow.
This disease is often found.The spread of monikomycosis in Europeans, according to some reports, reaches 10-12% of the previous decade.In men, this happens 1.5 times more often, but they contact the doctor twice fewer doctors.Older people get sick more, children are very rare.
The main problem in the treatment of the disease is that patients come to see a long time after the appearance of a dermatologist's first symptoms.Therefore, pathological mushrooms seize a large area and treatment is delayed.
The pathogenic mushrooms can only be passed by a sick person.Very often, the infection with a fungus occurs inside the family, because the source is not detected in time and is not adequate preventive measures.
Reasons for the disease:Direct contact with the most, patients or objects used (shoes, clothes, carpets, washing clothes, manicure supplies).Often the infection occurs when traveling to gym, baths, saunas and pools.
Development of the disease is facilitated by microments - a weak drying of dry skin, dry skin, dry skin, dry skin, dry skin and water procedures and straight legs.
Nail miksans can occur when using the endocrine system (diabetes, obesity, obesity, hypothyroidism), suspension diseases, immune disorders, as well as antibiotics, corticosteroids and cytostatic medications.As a result of the above-mentioned diseases, the micro period in the nail region is violated and natural immunity is reduced, which contributes to the development of the average infection.
OnychomycoAz leads to the types of fungi:
- Dermatophyte;
- Canus sexual mushrooms;
- Molds.
Depending on the type of pathogen, the penetration of a fungal infection and the clinical form is different, so the approaches to therapy are different.
Nails in the legs are more often affected by a mushroom than a mushroom.In most cases, dermatophytees cause fungi (eg trichophyton rubrum).The rest causes the most inconsistent molds (aspergillus, skopulariopsis, fusarium).
If similar symptoms are detected, consult a doctor.It is not self-to-do - dangerous to your health!
Symptoms of OnyComycosis (nail fungi)
How long does the disease last, how long does the signs declare.The main signs of the onyjomycosis are:
- Dyschromia - a change in the color of the nail yellow, black, green, gray or brown (color type depends on the type of fungus);
- Onycholiz - separation of the nail plate from the box;
- change in the thickness of the nail plate;
- Gapalonichia - the strength of the plate thickness and its softening;
- Koylonichia - the nail appears in a teaspoon shape of a concave;
- Pahionichia - the thickization of the nail plate, hypertrophy of the nail;
- OneCogrifosis - a change in the color of the color of the nail plate, curl in the form of shoots;
- Change in the thickness of the nail bed (hyperkerator - the thickization of the nail field);
- To change the surface of the nail plate: Potholes, fur, crests;
- Change nail rolls and surrounding skin (ParonyChy - Proximal nail rollers.
It is important to note that none of the symptoms are pathogenically suitable for a particular pathogen, so it is impossible to determine the symptoms - additional examinations are needed.
Pathogenesis of onyComycosis (nail fungi)
The pathogenesis of the disease depends on how the mushrooms hit the skin and nails.
Distal submarine type type:If mungus is applied with leather in the area of nail reels or distal region, the spread of the infection occurs later for the release edge of the nail on the bed and the matrix.Initially, the nail plate can not change, but later is gradually separated from nail bed due to hyperbuilderoz.Gradually, the nail plate is possible to thicken.
Surface White Type:If the nail is a bleaching form of focus on the surface, over time, the whole nail plate is the mushroom.The nail is thickened, collapsed, gray-brown.In this case, the matrix and epithelium of the nail field are not affected.The surrounding skin does not contain inflammation.
Proximately sub-writing type:Mushrooms can reach the nail cavity from leather and periodic rolls, then the distal parts of the nail plate.The stains in the nail polish in the nail and the nail bed are separated by nail plate.Nail bed or matrix have no open inflammation.
Total Dedosic Type:All nails are affected.The proximal regions of the nail wheel disappears or thicken, so the nail plate can no longer form and grow.
Be availableBiophysical understanding of the pathogenesis of onycchomycosisConflict between two force with the disease: a mushroom colony in the matrix and the natural growth of the matrix grows from the matrix to the distal edge.Therefore, the growth rate of nails is very important during the onyomycosis - the nail grows faster, before the treatment comes before.Perhaps this, which explains the small spread of the disease in children, the nails grow faster than adults and older people.
Classification and stages of the development of onyjomycosis (nail fungi)
Onycchomycosis has the following classification:
- Distal submarine;
- surface white;
- Proximately subway - way;
- General dystrophic.
According to the 1970 classification:
- Normotorophical: A strip of the nail thick, yellowish and minded, but the form of the nail plate does not change, there is no underwater hyperperactory;
- Hypertrophic:Nail plate is thickened due to yellow, underwater hyperperatoria, broken with broken edges;
- Dedrophic:The nail cavity has subtle and removal gaps from nail battles.
Constricts of onyComycosis (nail fungi)
Risk of development with longyxomycosis increasesdiabetic foot(The formation of trophical Ülkers in the legs) andgangrene, if the patient has diabetes or vascular diseases of the lower extremities.
In immunosuppressive conditions (primary and secondary immunity), fungi can be spread to the skin and the internal organs and cause the body allergies.This can indicate itself to the development of the bronchial asthma by the rashes.
Diagnosis of onycchomycosis (nail fungus)
Before disasseming the diagnosis of OnyChomycosy, it is necessary to explain how the material for research will be properly gathered (patient independent or prepare nails before diagnostics).Before the fence of the material for the study, another bacteria should be treated with 70% of the nail plate for lack of obstacles.
The method of collecting material varies in the form of onycchomycosis:
- Surface form- to make a crumb from the nail plate;
- Far form- You need a piece of a scrap and nail plate from the nail bed;
- Proximal submarine form- Material accumulates a scrap of a boring or nail biopsy or nail bed.
The fastest method for identifying pathological mushrooms on the nailmicroscopy.Techniques: The examined material is treated with an alkaline solution to solve alkaline.To make the fungal ropes better, the complex alkali is added.Then, learn the emerging medication under a microscope.
This research method is the fastest and most objective.Sensitivity is up to 80%.It is impossible to determine the pathogenic type when using the shortcomings of the method.
Bacteriological planting: It is an additional method of diagnosis of onychomycosis.The material is planted in a special environment and commented on the result under a microscope 2-3 weeks.This method allows you to create a pathogenic type - it helps to determine the tactics of treatment and selecting drugs.However, the disadvantage of the case is that it takes a lot of time and sensitivity is 30-50%.
Biopsy: With the help of a scalpel and cut in anesthesia, cutting a nail and nail bed.The material is immersed in a formaldehyde solution and is sent to the laboratory for histological examination.The advantages of this method are very sensitive and allows you to determine the presence of pathological fungi in the material.
Cons: It is impossible to determine the high price and complexity of microorganisms, methods, methods of microorganisms, as well as determine the accuracy of microorganisms.
Genodiaqnostics: Molecular biological research method (PCR).This is one of the new and highly sensitive methods for the diagnosis of onychomycosis - with its help, the DNA of the pathogen was revealed.This type of medical institutions with PCR laboratories are recommended to introduce this type of diagnosis, but the test systems are just planning to identify the lab to determine the mushrooms.The method allows you to determine the pathogenic type and its sensitivity is from 80-90%.Cons of high prices, inaccessibility, lack of technology standards and complexity of execution.
More doctors are applieddermatoscopy.Using this method, a change in the color and structure of the nail, you can assess the situation in the surrounding structures.Dermatoscopic examination allows you to better appreciate the depth of damage to the nail plate and calculate the index of the violence on the onychomycosis.
Treatment of Onychomycoz (nail fungi)
There are several types of treatment for onychomycosis:
- Local therapy.
- System therapy.
- Combined therapy.
- Corrective therapy.
Local therapyContains drugs to apply to nail plate and nail rolls.Tips for local therapy:
- Limited form of damage to the nail plate.
- There are reverse hints for setting systemic medications: sensitivity, liver disease, kidney function, pregnancy, lactation.
The advantages of this therapy are the formation of a therapeutic agent on the surface of the nail that does not penetrate the bloodstitions of high concentrations.The use of antifungal drugs does not have side effects - nausea, appetite, abdominal pain decreasing.The disadvantage of the method is that the drug is not always in the institution of pathogen, especially if the mushrooms are located in the nail bed or matrix.This, in turn, can lead to the inefficiency of treatment.This type of treatment is often - before applying the medication, it is necessary to remove the affected part of the nail.
Ways to remove the affected nails:
- Mechanical extract with files, nippers or drilling.
- With the help of keratolitic placards.Before applying a keratolytic patch, the skin around the nail is sealed in a patch, the patch mass (a carbamide with salic acid) is applied above and sealed with a gypsum adhesive.Patch mass is changed every 2-3 days.After each removal, the affected part of the nail is mechanically removed.
- Surgical.This operation is very painful and traumatic, because since the nail plate removes, the germinate zone can be damaged, which leads to the growth of deformed nails.
Local antifungal agents are used after removing the affected nail plate.AntimioticotechnicsDistinguish between the location of the application:
- applied to the nail: varnishes;
- Contact the roller: creams, ointments, solutions.
The most studied tool for local use is a 1% solution of the medication of the Allam's group with an evidence-based evidence of treatment in treatment based on crocranny meta-analysis.This vehicle has a water base that contributes to better reputation to the destruction of the antifungal substance.Lacquers are a thirsty base that reduces the prestige of the drug to the deep layers of medicine.Therefore, dermatologists use the use of varnishes unsatisfactory and more water-frequent water.
It is important to observe the treatment regime to obtain the result from local therapy, it is important for the patient to be responsible, consistent and patient.The term of therapy can reach 12 months.
System therapyAlthough the antifungal drug, nail bed and matrix are affected, allow to penetrate through blood in the lesion.The high concentration of the drug remains a long time in the lesion after the end of the use.The shortcomings of such treatment are associated with the risk of side and toxic impact.
Tips for systemic therapy:
- General forms of damage to the nail plate.
- Lack of local therapy (ie after six-month onyjomicosis treatment, 9-12 months of treatment of the feet 9-12 months of treatment, there were no treatment, healthy nails).
The clinical index of the violence of OnyComycosis is used to determine the treatment tactics.Used as a therapeutic standard in different countries of the world.
The drugsFor the treatment of Onychomycoz you can classify as follows:
- Antimototic - there is an antifungal effect;
- Antiseptics - both antifungal and antibacterial effects.Rarely used, only if there are no other antifungal agents;
- Multicomponent - In addition to the Antifungal Agent, it contains other medications such as antiinflamation.
Drug to determine drugs:
- Standard - Daily administration of drugs during the defined treatment period;
- shortened - treatment period shortened, ordinary doses or enlarged;
- Intermediate - treatment is determined in several short days, breaks between courses are equal to courses;
- Pulse therapy-treatment is prescribed in several short days, breaks between courses are larger than the course.
Annotifal medications are divided into active substance:
- Triazols;
- Alllamins;
- Morpholins.
System therapy is currently usedOnly third-stage drugs.
With combined therapyLocal and systematic treatment is carried at the same time.In combined therapy is used if you need to increase the effectiveness of systematic therapy and reduce treatment periods.
Habit therapy(Treatment of infectious diseases): To select a treatment regime, you need to assess the common sense of the body.Diseases such as blood circulation disorder in restrictions can reduce the entry of an antifungal agent.Therefore, medications that improve the tissue trophic are determined.
Systematic antifungal drugs need to exclude liver diseases due to the poisonous effects and to determine hepatoprotectors if necessary.
The forecast.Prevention
The patient will be the sooner the doctor, which has signs of nail lesions, will treat the disease faster and restore the nail plate.The treatment of onychamycosis can be long, restored, restored, with all the recommendations, with long-running processes with the capture of the entire nail.If there are opposite instructions for systemic therapy, long-term supporting treatment is necessary with local drugs.
For the preventionTo follow the rules of personal hygiene and reduce the probability of re-election:
- Try to wear comfortable and high-level shoes (to prevent increasing sweating of feet);
- It is recommended to change daily socks and tights;
- Only use individual shoes.Those who passed for the onychomycosis should be treated at the beginning of treatment, at least once in the whole period of treatment;
- If necessary, use antiperspirants for your feet;
- Use an individual nail care set (scissors, saws);
- Use the public places (pool, bath, gym) and after visiting and after antifungal foreign products (sprays, rules and pens);
- To determine the source of a fungal infection in the family and treat it at the same time.
It is recommended to carry out antifungal processing of personal items, shoes, baths, floors and rugs.For these purposes, 40% of acetic acid, 1% of antiseptic 1% alcohol solution (determined by recipe solution), you can use solutions for disinfection.The underwear can boil up to 1-2% of artificial, soap lining solution at maximum temperatures.