Nail fungus (onychomycosis) in the feet is a disease developed due to damage to the nail plate with mushrooms with dermatophytes (up to 96%), less often mold and yeast -like (about 4%).The most common infection spreads from the skin with long micosis in the feet.Here it finds good conditions for development - increased moisture and nutrients.Under the influence of pathogens, the structure is disturbed and the color of the nail plate changes.Over time, their complete destruction occurs.
Onychomycosis is not only a cosmetic defect, but also a serious disease, subject to timely detection and adequate treatment under the supervision of a dermatologist.
The fungus on the feet is recorded in millions of people in the world.About 5% of the population has onychomycosis.The most widespread disease is common in people 50 - 60 years.Every second person is ill in this age group.Pathological treatment is difficult for them due to the presence of somatic pathology, especially vascular and endocrine.Men are sick more often than women.Parents are more sick than young people.Children rarely suffer, especially suffering from serious illnesses.With AIDS, the disease has an unusual picture.
The causative agent of onychomycosis
The cause of onychomycosis in the feet is a variety of mushrooms: dermatophytes, yeast -such as or mold mushrooms separately or in combination.
- Dermatophytes mushrooms account for up to 90% of all onychomycosis.They are represented by the genus genus trichophyton (most often T. rubrum and t.mentagrophytes var interdigitite).Often, the nail plate on the feet is affected by the trichophyton rubrum.Dermatophytes are common in countries with moderate climate.
- Fungus such as the yeast genus candida onhomycosis in the feet rarely causes.They contribute about 3% of all onychomycosis.In addition to Candida Albicans, mushrooms such as S. Tropicalis, S. parapsilosis and S. Guillermondii also cause the disease.
- Most mold mushrooms cannot cause their own nail fungus.Only a few of their species are free pathogens - these are scytalidium hyalinum and S. dimidiatum (nattrassia magniferee), which is not lower in pathogenic to dermatophytes.Onychomycosis in the foot is a mold such as scopulariopsis brevicaulis, aspergillus spp.et al.These infections are most common in countries with hot and humid climate - tropics and subtropics.
Epidemiology of a disease
Most onychomycosis is an anthropophilic infection.They are sick and spread infections especially people.
Dermatofit mushrooms
Reservoirs and sources of dermatofit mushrooms are sick people whose pathogens are sent with direct contact or personal items.Infection almost always extends to the nails in the foot with the affected legs, the disease is clearly continued and silent (the form of mycosis).The risk of infection increases repeatedly with the presence of disease in one of the family members.
Mushrooms are transmitted through shoes, clothing, files and nippers infected for nails, rugs, linen, towels, towels, and more.Delivery of infections occurs when a normal bathroom, in the bathroom, sauna, swimming pool, gym and on the beach.It contributes to the entry of mushrooms to the feet by walking barefoot in the general area.Pathogens live for a long time on wood and floors.
Yeast -like mushrooms
Mushrooms like yeast from the genus Candida are saprophytic flora and always live on one's skin.A good immune system is prevented by pathogenic growth.Antibiotics, contraceptives, glucocorticoids and cytostatics, endocrine pathology (often diabetes mellitus) and some diseases understood the immune system.Explosive mushrooms penetrate nails from the skin and mucous membranes of the patient, or enter the human body with infected products rich in carbohydrates.
Cast
Molds live in the ground.Their disputes fall on products, things and environmental objects.Nedimatophytes are not spread among people.
Risk factors for the development of a disease
For mushrooms, dermatophytes are characterized by hereditary tendencies, male sex, old age, vascular disease, diabetes mellitus, immunodeficiency conditions, increased sweating, nail injury and the presence of other dermatomycosis.
Mushroom infections such as yeast genus candida are characterized by increased temperature and moisture, immunodeficiency conditions, increased blood glucose, nail injury and non -compliance with the rules of personal hygiene.
For infections with mold mushrooms, severe immunodeficiency conditions and nail injuries are characteristic.
Groups at risk
The risk group of onykhomycosis development includes:
- People who always use locker rooms, baths, sauna, etc.
- Professional athletes (swimmers, football players, athletes, and others).
- Military personnel and other groups of people who use proprietary shoes.
- Men's face.
- Age older than 60 years old.
Contributing to the development of fungus in the foot:
- Wear tight and tight shoes.
- An increase in sweaty or dry feet.
- Injuries and nails, foot scuffs, nails grow, etc.
- Accommodation in wet and hot climate.
- Walking barefoot in public places.
- The presence of skin diseases where nail keratinization (psoriasis, ichthyosis) is disrupted.
- Diseases such as diabetes mellitus, immunodeficiency conditions, low blood circulation disorders, blood disease, corticosteroid intake, antibiotics and prolonged cytostatic.
- Genetic predisposition.
Fleet Fungal Development Route
There are several ways to penetrate the mushrooms into a nail plate:
- Distal or distal-lateral (from free or lateral).
- Shallow (directly through the nail plate).
- Proximal (subtyo -gut).
Distal-Lateral Road Mushroom penetration
The distal or distal penetration path is a characteristic of trichophyton rubrum mushrooms.The pathogen is introduced into the nail plate from the free edge (distal) or side area (side edge).The main inflammation process occurs on the nail bed, where enhanced cell proliferation occurs.The skin layer on the flagship of hyperkeratosis (hyperkeratosis), as a result of the nail plate lifting and peeling (onycholysis).
Further, the infection spreads towards the hole and penetrates the nail plate, which gradually (slowly) destroyed.With damage to the matrix, the amount of dystrophic onychomycosis occurs.
Nail bed hyperkeratosis is observed in chronic eczema, psoriasis, warts, red flat lichen.
The shallow path of the spread mushroom
Trichophyton mushroom mentagrophytes var.Interdigitite is more aggressive in relation to the horny structure of the nail plate than other dermatophytes.They mainly affect the outside of the nail plate, causing the development of white surface onychomycosis.Mushrooms under the influence of keratinaz enzymes touch the stratum layer with hiphae, gradually catch all layers of nail plate.Most 1 and 5 toes are affected.They are subject to the biggest shoe trauma while walking.In this disease, 1 and 4 intercal folds are affected.
It is believed that the shape of the onychomycosis surface can also be caused by fungus-humanatophytes: Acremonium spp., Fusarium oxysporum and some aspergillus.
Proximal mushroom distribution route
There is the third path of mushroom penetration into the nail plate - through proximal nail roller and nail beds.The defeat begins with the skin in the nail roller area, which thickens and peels off the surface of the nail.Further, the end of the matrix and nail beds are involved in the process, with the damage to which the advantages, deviations and cracks appear on the nails.With the penetration of the pathogen into the nail plate, the nails get the white color of the white over time.Over time, complete destruction and loss of nail plate are observed.It is more often found in HIV -infected patients with the spread of infection through the blood vessels.
Features -damage to yeast -It's like the genus Candida mushrooms
Damage to the genus Candida mushroom begins with paronichia - inflammation of the proximal roller (located near the hole).Edema and thickening are observed, leading to the cutting of the cuticle from the surface of the plate.Further, free mushrooms fall into the matrix and nail bed, causing, causing nails from the finger tissue over time.
Features -The damage to mushrooms by incorpoons
Nail damage to mushrooms with non -virtatophytes is secondary.Mold (usually scytalidium sppNext, hyperkeratosis and slow destruction of the nail plate develop.
A form of clinical onychomycosis in the leg
There are several forms of onychomycosis in the feet:
- Distal-Lateral.
- Shallow white.
- Proximal.
- Dystrophic amount.
Onychomycosis of the distal-lateral submarine on the feet
The form of this disease is the most common.In most cases, the cause of onychomycosis is dermatomycetes, especially trichophyton rubrum.The pathogen penetrates the nail plate from the side of the free and side edge.Perenophaeum hyperkeratosis develops, as a result of a nail detachment from the finger tissue (onycholysis), it loses transparency, acquires white or yellow, begins to collapse.With the development of submarine hyperkeratosis, the nail plate appears to be thick.With the development of the disease, the focus of the lesion develops towards the hole, as shown by the new yellow stripes.Over time, the entire nail plate and matrix are involved in the pathological process, which from time to time leads to the nails and nail destruction.
In the elderly, it is called hyperkeratosis (thickening), onychographosis (thickening and deformation in the form of chicken paw) or coilonichia (concave deformation) is often observed.Their nails are often affected by mixed flora - dermatophytes, mold and even bacteria.
A form of surface onychomycosis (white) on the feet
Onychomycosis of white surface on the feet is the second largest form of damage.The cause is mainly trichophyton mentagrophytes var.Interdigitite, which penetrates the nail plate directly through the top (pre -rsal), as well as several types of fungi -hectophytes.Mostly influenced by nails on the first leg, less often - fifth.
Initially, small white spots and strips appear on their surface, eventually capturing the growing surface.Gradually, the color becomes yellow, ocher.The nail surface becomes loose, coarse, powder, easily jumping.The thickening and separation from the nail beds did not occur.
The form of a proximal submarine onychomycosis in the leg
This form of mycosis is rare.He contributes about 3% of all onychomycosis.The reason is that mushrooms like the Candida Albicans and Trichophyton Rubrum.The nail candidiasis is preceded by the inflammation of the periological roller.It swells, gets red, becomes excellent.The cuticle is lifted and the infection penetrates the end of the matrix and the nail bed, when it is damaged by shells, distortions and cracks on the nail plate, loss of natural excellence and clouds are recorded.Gradually, the nails are destroyed, in cases of severe disappearance.These forms of onychomycosis in the feet are often found in HIV -infected patients.
The total form of dystrophic onychomycosis in the legs
This form of onychomycosis is more commonly developed with long (chronic) current disease, which is more commonly trichophyton rubrum and Candida albicans.At the same time, nail plates, beds and matrixs are involved in the pathological process.Exceptions to nails occur as a result of the development of submarine hyperkeratosis.Over time, the nail plate is destroyed, and the new ones due to the affected matrix does not grow or grow badly.
Type of damage to the nail plate
There are 3 options for onychomycosis:
- Normotorophical.
- Hypertrophic.
- Atopic.
The normotropic type of onychomycosis in the leg
With the normotropic type, the infection is localized in the upper layer of the nail plate.The thickness and color of the disease does not change, but the spots and strips can be seen in depth.The color of the nails varies from white to saturated yellow.After some time, the spots and the stripes combine.The damage area spreads throughout the nail plate, excluding the moon.Breaking and cringing are not followed.Sometimes a slight relaxation of free advantages is observed.With adequate treatment, the antidote is possible.
Hypertrophic onychomycosis type in the legs
This type of onychomycosis is the most common.As a result of the development of submarine hyperkeratosis, the nail plate is very thick, defective and shining.The nails become uneven, tedious, get gray and collapse.The moon area is not affected.The disease gives a significant discomfort of the patient.In elderly patients, the development of onychogrifosis is observed - nails thick, prolong and bends like bird claws.
The type of atropic onychomycosis in the legs
With atrophic (onycholithic) types, the nail plate quickly loses its connection from the nail bed, many hollows appear in the layer, it fades, becomes thinner and turns white or white.The surface remains smooth for a long time.Over time, partial destruction occurs.
The signs and symptoms of nail fungus
Often, nail changes begin with a free (distal) or lateral (lateral) advantage.
Color change.With onychomycosis, the color change of the nail plate is the first sign of the disease.It becomes opaque, often loses shining, acquiring white or yellow, with overlapping with mold mushrooms - brown, brown, green and even black.
Thickening.Increased volume of horny masses due to the development of submarine hyperkeratosis leads to thickening of the nails.
Crushing and destruction.In the case of illness due to the important activity of mushrooms, the first nail plate collapsed and so on, over time, completely destroyed.
Characteristics -Features of nail damage with different types of onychomycosis
Nail damage to various types of fungal diseases has its own features.The main types of pathogens are Trichophyton Rubrum (70 - 90%) and Trichophyton mentagrophytes v.Intererdigital (8 - 30%).Candida albicans, mushroom mushrooms, T. mentagrophytes v.gypseum, T. Verrucosum, T. Tonsuras and T. Violaceum, epidermophyton floccosum, Trichophyton is much more common.Schonleinii.
Onychomycosis on the feet with rubrophytia
Rubrophytics in the Russian Federation account for 70 to 90% of all micosis.The feet in this disease are most often affected (usually squamous-dry).The most needed satellite rubrophytia is the nail fungus on the feet.With mycosis, the form of distal-dilutal onychomycosis usually develops, called hyperkeratosis is characteristic, some fingers in the toe are affected at once and often fingers in the one hand.The disease continues without a special subjective sensation.Pain and discomfort when wearing shoes occur with hyperkeratosis, onichogrifosis and sinking nails.The source of infection is often in the patient's family.
Often, the related onychomycos are recorded: Trichophyton Rubrum and Candida Albicans, Trichophyton Rubrum and mold.It is important to evaluate cultural studies.
Onychomycosis on the feet with t.Mushroom mushrooms.V.Intererdigitite
Mushroom T. mentagrophytes.V.IntererDigitite affects the skin and nails.Epidermophytosis accounts for 10 to 30% of all foot mycosis.
With this disease, the upper (dorsal) of the nail plate is affected.The form of shallow white onychomycosis usually develops.The pathological process is mostly involved in 1 and 5 toes (they are subject to the largest trauma by shoes while walking) and 1 and 4 interpack folds.Delivery of infections occurs when using regular baths, in the bathroom, sauna, swimming pool, on the beach and swimming pool.
Onychomycosis on the feet with damage to mushrooms such as yeast genus Candida
This form of mycosis in the feet is rare.It accounts for less than 3% of all onychomycosis.Often the disease is recorded in people with chronic candidiasis.Damage to the nails, as a rule, begins with inflammation of the periological roller located near the hole.Edema and thickening are observed, leading to the cutting of the cuticle from the surface of the plate.Further, free mushrooms fall into the matrix and nail beds (proximal sub-nible shapes), if grooves, distortions and cracks appear on the nails, loss of natural excellence and clouds appear, brown brown shades.Gradually, the nails are destroyed, in cases of severe disappearance.
Onychomycosis on the feet caused by mold
Plastic mushrooms are inhabited into affected nails - cracks, into space between nail polish or lonely vessels.Next, hyperkeratosis develops and slow down the nail plate, which during the disease is in black (scytalidium spp
Diagnosis of onychomycosis
The diagnosis of onychomycosis is based on data from epidemiological history, clinical picture of the disease and data of laboratory research methods.
During the microscopic examination of the substance, the nature of the disease (mushrooms or other pathogens) is established.The identification of mushrooms is established with microbiological examination (material plant on nutrient medium) with subsequent microscopy of pure culture.This process is difficult, success is achieved in half cases.Proper collection of materials from affected nails is key to successful microbiological studies.
Differential diagnosis
Only in half of the cases of patients with dermatologists with changes in the shape and color of the nails make fungal disease.Onychomycosis should be distinguished from eczema, psoriasis, Reitera syndrome, pachionichia, Daria disease, flat lichen, Norwegian sores, bacterial lesions.