What Is Onychorrhexis?

Onychomycosis, commonly known as "onychomycosis", refers to diseases caused by dermatophytes invading the deck or under the nails. Onychomycosis is an onychomycosis caused by fungi such as dermatophytes, yeasts, and non-dermatophytes. Common types of onychomycosis: Mycotic white nail (superficial white onychomycosis) This type of lesion is limited to one piece of the nail surface or its tip; Type and superficial white type, this type of lesions start from both sides or distal of the nail, and then under the deck infection.

Basic Information

nickname

Onychomycosis

English name

tinea unguium

English alias

onychomycosis

Visiting department

dermatology

Common causes

Caused by Trichophyton rubrum, Trichophyton rubrum, Epidermophyton floccus

Common symptoms

Diseased nails are turbid, thickened, uneven surface, brittle and fragile, etc.

Causes of onychomycosis

Onychomycosis is often caused by various fungi such as Trichophyton rubrum, Trichophyton trichophyton, and Trichophyton flocculatum. A few are caused by other filamentous fungi, yeast-like fungi, and yeast, and occasionally by spores, Fusarium, Aspergillus terreus, etc. Most are found in malnourished nails.

Clinical manifestations of onychomycosis

1. A type of onychomycosis

It usually starts from the sides or ends of the deck, and usually has mild paronychia, and then gradually becomes chronic or gradually subsides. Paronychia can cause pits or grooves on the nail surface, which can persist or gradually affect the nail roots. Once the deck is infected, it can crack, become brittle, or thicken, appearing brown or black. This type is common. Due to the deposition of inferior keratin and debris, the nail becomes loose and the nail becomes cloudy and hypertrophic.

2. Fungal white nails (superficial white onychomycosis)

It is one or more small turbid areas on the deck surface, which has an irregular shape and can gradually spread to the entire deck, causing the nail surface to soften and sink. No symptoms, no paronychia, often seen in the nail bed wrinkled skin, scaling.

3. Onychomycosis caused by Candida albicans

More common in housewives, cooks and people who often come into contact with water. It is often combined with paronychia, which starts from the nail folds on both sides, and may have reddened skin, pus, and tenderness. Nearby nails turned dark, rose, and separated from the nail beds beneath them, and the entire deck spread afterwards.

Onychomycosis

The fungus can be easily found by PAS staining of the inferior onychomycosis, and the hyphae and joint spores are confined to the lower part of the deck.

The fungal hyphae of fungal white nails are confined to the uppermost part of the deck and rarely spread to deeper layers. A large number of hyphae and irregular joint spores are seen on the upper deck, which are larger and wider than those seen in the sub-A type.

Onychomycosis diagnosis

Clinical manifestations combined with fungal examination are not difficult to diagnose. Fungal examinations include direct microscopy, fungal culture, and histopathological examination. Direct microscopic examination of fungi is simple and easy, and its clinical application is widespread.

Onychomycosis treatment

Onychomycosis is the most stubborn and intractable form of dermatophytosis. Can be taken orally, topically, or surgically. The growth rate of fingernails and toenails is different. It takes 100 days to completely replace a new nail, while toenails take about 300 days, so patience must be treated.

Surgical nail removal

Suitable for single hair nails, remove the affected nails under local anesthesia. This method has large wounds, bleeding, and easy to cause infection. It usually feels more painful after surgery, and it is easy to re-infect and relapse. Patients with heart disease, hypertension, and diabetes should not be treated surgically.

2. Oral medication

Suitable for multiple fingernails. For example, take oral terbinafine 250mg orally for 6 to 12 weeks; itraconazole 400mg / day, take 7 days and rest 21 days as a course of treatment, lasting 3 to 6 courses; 1 to 2 times a week 150 mg of fluconazole for the second time, more than 4 consecutive months. Can cure more than 80% of onychomycosis and onychomycosis. However, because such drugs must reach the deck where the fungus is parasitic in order to exert antibacterial effects, the drug is used in large quantities and for a long time, and adverse drug reactions should be monitored regularly.

3. Topical therapy

According to the different medicaments, the main methods are local application and package cutting.

(1) Use a nail file (non-professionals must not use a blade to prevent bleeding from infecting other diseases). Thin the irregular nails, and the nail grinding cycle is preferably once every 2 days;

(2) 30% glacial acetic acid is applied or 10% glacial acetic acid vesiculi, once a day, for more than 3 to 6 months. If the nail is thinned before application, the effect is better. Before applying nails, pay attention to protect the skin around the nails with a mild ointment;

(3) Locally apply antifungal agents such as terbinafine, tincture of amorolfine, ciclopirox and other antifungal agents.

In short, persistent treatment of onychomycosis. At the same time, it is also necessary to actively treat ringworm and chronic systemic diseases in other parts of the body, improve self-resistance, and pay equal attention to prevention and treatment, so that it is possible to completely cure onychomycosis.

Onychomycosis prevention

For the prevention of onychomycosis and onychomycosis, the first is to actively prevent and cure common ringworm diseases, and fungal infections should be prevented when there is malnutrition of onychomycosis.

Environmental factor

High temperatures and high humidity are important conditions for the frequent occurrence of ringworm. Therefore, ringworm in summer and rainy seasons is more severe than winter and dry seasons. Some drought-resistant and cold-resistant ringworms still cause disease in cold and dry seasons, which is more common in northern China. The working and living environment of patients cannot be ignored. Well-ventilated places have a lower incidence than airtight, stuffy places. Crowded areas are highly ill. It can be seen that occupations and types of work have a great impact on the incidence of ringworm. In high-temperature, high-humidity workshops, especially in poorly ventilated environments where heavy work clothes must be worn to produce, it is susceptible to ringworm. Without bathing equipment or failure to take a timely bath, the incidence of ringworm will increase significantly.

Personal factors

Men, women and children can get sick. Generally speaking, young men and women are more susceptible; those who love sports and active sweating are also more susceptible. Ringworm is not inherited but has a family susceptibility. Personal hygiene is directly related to ringworm. People who come into contact with public baths and poor sanitation pools are susceptible to ringworm. Pets such as cats and dogs are susceptible to ringworm infections on pets. Certain chronic diseases such as malnutrition, hyperthyroidism, and ringworm in patients with diabetes are common and the symptoms are more severe. Some severe cases, such as patients with AIDS and advanced cancer, not only have a high incidence of fungal ringworm, but also have a wide distribution of ringworm, which is peculiar and very stubborn. When the underwear is too thick and too tight, it is easy to induce jock itch. People who often sit on the toilet are more likely to develop jock itch than those who don't. Those who do not shower in time after swimming are susceptible to ringworm and tinea versicolor (sweat spots). In addition, people who bathe frequently, who like scratching, can easily implant fungal dander into the affected area or spread it elsewhere to develop ringworm.

Onychomycosis

Affect aesthetics

As the saying goes, "The hand is the second face of a person". The beauty of the hand directly affects a person's temperament. And the beauty of the hand is largely in the nails. Having onychomycosis in the hands is indeed a hindrance to aesthetics, and the patients shake hands and feel embarrassed.

2. Restrict work

The consequences of damaged nails are not limited to the viewing itself, but will affect or even endanger the work of the patient, especially some professions with high profile and strict hygiene requirements. Such as doctors and nurses, catering industry, silk weavers, public relations and other jobs.

3. Affect daily life

Humans are inseparable from the assistance of nails in the tasks of threading, writing, cooking, typing, knitting, and playing. Once you have onychomycosis, this type of work will be disrupted. Fingernails have a protective effect on the end of the hand. Once sick, the hand will be easily injured by collision.

4. Generate abnormal psychological disorders

Patients with onychomycosis, especially when long-term treatment fails, often have a sense of distress and frustration that cannot be rid of. Especially when work, marriage, and society fail due to the effects of onychomycosis, the psychological impact on patients is greater, which often results in a sense of inferiority.

5. Many complications

Onychomycosis can cause pain and discomfort, and easily cause complications such as paronychia, onychomycosis, and finger pus dermatosis. In severe cases, systemic symptoms of deep tissue and organ infections such as erysipelas or cellulitis can cause serious diseases, and even harm life. Female sibs suffering from onychomycosis can be transmitted to the genitals, forming difficult-to-cure gynecological diseases such as fungal vaginitis and candida albicans vaginitis.

6. Become a source of human infection

People with onychomycosis can easily become a source of fungal infections. Patients can infect fungi to other parts of the body with scratching, which can cause new ringworm disease, which can be transmitted to family and friends in severe cases. Relatives and friends are often infected by changing shoes, touching hands and feet, and sharing daily necessities. Once infected, they can easily develop severe skin diseases such as ringworm, tinea corporis, and erysipelas.

Four attention to onychomycosis

Watch out for lesions

There are many reasons for nail changes, and nail diseases cannot be considered to be onychomycosis. However, one thing to grasp is that the onset of onychomycosis often starts with one fingernail, and then gradually spreads to other fingernails. If ten fingernails or toenails develop at the same time, it is often a manifestation of a systemic disease and a thorough physical examination is required.

2. Timely treatment

It is best to choose April to September of the year for treatment. Everything grows most vigorously in spring and summer, as is nails. Choosing a suitable and effective treatment in this season can shorten the treatment time by one-third, Patient impact is minimized and costs are minimized.

3. Pay attention to cross-infection between family members

According to statistics, about 30% of family members of onychomycosis patients in China also have different degrees of foot mold infection. People often ignore the severity of onychomycosis, and only when they treat outbreaks of fungal infections in other parts of the body will they find hands and feet with onychomycosis. Many of these patients' infections come from their families.

4. Don't treat yourself after infection

Onychomycosis is a chronic fungal infection that requires active treatment. It is best to go to a regular hospital for a relevant mycological examination and determine it as onychomycosis. Under the guidance of a doctor, choose a suitable treatment plan to avoid the diagnosis of unidentified medication.