Images of infected fingernails. Nail Diseases: Symptoms, Causes, and Treatments for Common Conditions
What are the most common nail diseases. How can you identify symptoms of nail psoriasis, fungal infections, and other conditions. What treatments are available for various nail disorders.
Understanding Nail Psoriasis: Causes, Symptoms, and Treatment Options
Nail psoriasis is a condition that can affect individuals living with psoriasis. It occurs when psoriasis impacts the skin of the nail bed or surrounding areas. Recognizing the symptoms of nail psoriasis is crucial for early intervention and proper management.
What are the telltale signs of nail psoriasis?
Nail psoriasis can manifest in several ways, including:
- Crumbling or dented nails
- Pitting on the nail surface
- Color changes, often to yellow or brown
- Accumulation of skin beneath the nail
- Blood under the nail
- Separation of the nail from the bed
If you notice these symptoms and have a history of psoriasis, it’s advisable to consult your healthcare provider. Early detection can lead to more effective treatment and prevent further nail damage.
How is nail psoriasis treated?
Treatment options for nail psoriasis are diverse and tailored to the severity of the condition. Some common approaches include:
- Potent corticosteroid creams to reduce inflammation
- Tazarotene, particularly effective for addressing pitting and discoloration
- Calcipotriol to manage skin buildup under the nails
- Corticosteroid injections for more severe cases
- Laser treatments to target affected areas
Your dermatologist will determine the most suitable treatment plan based on your individual case and overall health status.
Brittle Splitting Nails: Causes, Symptoms, and Prevention Strategies
Brittle splitting nails, medically known as onychoschizia, is a prevalent concern that dermatologists frequently encounter. This condition can lead to nails that are fragile, soft, and prone to splitting or thinning.
What factors contribute to brittle nails?
The most common culprit behind brittle nails is repeated exposure to water, followed by drying. This cycle weakens the nail structure over time. Less frequently, brittle nails may be indicative of underlying health issues such as iron deficiency or other medical conditions.
Interestingly, the location of symptoms can offer clues about the cause. When both fingernails and toenails are affected, it often suggests an internal factor. Conversely, if only the fingernails show symptoms, external causes are more likely to blame.
How can you protect and strengthen brittle nails?
To combat brittle nails, consider the following strategies:
- Regular moisturizing of nails and surrounding skin
- Minimizing exposure to harsh chemicals
- Wearing gloves when performing household chores involving water
- Maintaining a balanced diet rich in biotin and other nail-strengthening nutrients
- Using a nail hardener or strengthener as recommended by a dermatologist
By implementing these measures, you can help restore strength and resilience to your nails over time.
Onychogryphosis: The Ram’s Horn Nail Condition Explained
Onychogryphosis is a distinctive nail disorder characterized by excessive growth and thickening of the nail, most commonly affecting the big toe. This condition can result in a portion of the nail growing disproportionately longer than the rest, often resembling a ram’s horn – hence its colloquial name.
What causes onychogryphosis to develop?
Several factors can contribute to the onset of onychogryphosis:
- Genetic predisposition
- Physical trauma to the nail or surrounding area
- Poor circulation, particularly in the extremities
- Underlying skin conditions such as psoriasis or ichthyosis
- Neglect of proper nail care, especially in elderly individuals
Understanding the root cause can help in determining the most appropriate treatment approach.
How is onychogryphosis managed and treated?
Management of onychogryphosis typically requires professional intervention. Treatment options may include:
- Regular trimming and filing by a podiatrist or dermatologist
- Patient education on proper at-home nail care techniques
- Use of specialized nail softening products
- In severe cases, surgical removal of the affected nail and nail bed
It’s important to note that complete nail removal is generally considered only when other treatments have proven ineffective or if the condition significantly impacts quality of life.
Ingrown Toenails: Prevention, Symptoms, and Treatment Approaches
Ingrown toenails occur when the edge of the nail grows into the surrounding skin, potentially causing pain, swelling, and in some cases, infection. This common condition can affect individuals of all ages but is particularly prevalent among adolescents and young adults.
What factors increase the risk of developing ingrown toenails?
While genetics can play a role in predisposing individuals to ingrown toenails, several other factors can contribute to their development:
- Improper nail trimming techniques
- Wearing shoes that are too tight or narrow in the toe box
- Repeated trauma to the toes, such as in certain sports
- Nail conditions that cause abnormal growth patterns
By addressing these risk factors, many cases of ingrown toenails can be prevented or their recurrence minimized.
How can ingrown toenails be effectively treated?
Treatment for ingrown toenails varies depending on the severity of the condition:
- Conservative home care: Soaking the affected foot in warm water several times daily, wearing comfortable shoes, and keeping the area dry
- Over-the-counter pain relievers: Acetaminophen or ibuprofen can help manage discomfort
- Professional intervention: In more severe cases, a healthcare provider may partially or fully remove the ingrown portion of the nail
- Antibiotics: If an infection is present, oral or topical antibiotics may be prescribed
For recurrent cases, your doctor might recommend a procedure to permanently prevent regrowth of the problematic nail edge.
Nail Fungal Infections: Identification, Risk Factors, and Treatment Options
Nail fungal infections, also known as onychomycosis, are common conditions that can affect both fingernails and toenails, though they are more frequently observed in toenails. These infections can lead to thickening, discoloration, and increased fragility of the nails.
How do nail fungal infections develop and spread?
Fungal nail infections typically occur when various types of fungi or molds enter through small cracks in the nail or the surrounding skin. Several factors can increase the risk of developing these infections:
- Excessive moisture around the nails, often from sweating or prolonged exposure to water
- Preexisting conditions like athlete’s foot
- Frequent manicures or pedicures, especially in salons with inadequate sanitation practices
- Weakened immune system
- Poor circulation, particularly in the extremities
Understanding these risk factors can help in implementing preventive measures to reduce the likelihood of infection.
What are the most effective treatments for nail fungal infections?
Treating nail fungal infections can be challenging and often requires patience. The most common approaches include:
- Topical antifungal medications: Applied directly to the affected nails, these can be effective for mild to moderate infections
- Oral antifungal drugs: Prescribed for more severe or resistant cases, these medications work from within the body
- Nail removal: In extreme cases, temporary or permanent removal of the affected nail may be necessary
- Laser therapy: A newer treatment option that shows promise in some cases
It’s important to note that successful treatment can take several months to a year, as the infected nail needs to grow out completely. Consistency in following the prescribed treatment regimen is crucial for optimal results.
Onycholysis: Understanding Nail Separation and Its Underlying Causes
Onycholysis is a condition characterized by the painless separation of the nail from its bed, typically starting at the tip and progressing towards the cuticle. This separation can occur gradually over time and may be indicative of various underlying health issues or external factors.
What are the primary causes of onycholysis?
Onycholysis can result from a wide range of factors, including:
- Physical trauma to the nail
- Excessive nail filing or use of harsh nail products
- Prolonged exposure to water or chemicals
- Allergic reactions to nail products or other substances
- Skin conditions such as psoriasis or eczema
- Fungal infections
- Side effects of certain medications
Identifying the specific cause is crucial for determining the most appropriate treatment approach.
How is onycholysis diagnosed and treated?
Diagnosis of onycholysis typically involves a thorough examination of the affected nail(s) and consideration of the patient’s medical history. In some cases, additional tests may be necessary to rule out underlying conditions. Treatment strategies for onycholysis may include:
- Addressing the root cause, such as treating an underlying skin condition or fungal infection
- Avoiding further trauma to the affected nail
- Keeping the nail dry and clean to prevent secondary infections
- Using topical treatments as prescribed by a healthcare provider
- In severe cases, temporary removal of the affected portion of the nail to allow for proper regrowth
It’s important to note that the nail will typically reattach to the nail bed as it grows out, but this process can take several months. Patience and consistent care are key to successful management of onycholysis.
Maintaining Healthy Nails: Prevention and Care Strategies
While various nail conditions can affect individuals, many can be prevented or mitigated through proper nail care and overall health maintenance. Implementing a comprehensive approach to nail health can help keep your nails strong, resilient, and less susceptible to common disorders.
What are the best practices for promoting nail health?
To maintain optimal nail health and reduce the risk of developing nail conditions, consider the following strategies:
- Keep nails clean and dry to prevent bacterial and fungal growth
- Trim nails regularly and file them in one direction to prevent splitting
- Avoid biting nails or picking at the surrounding skin
- Wear protective gloves when working with water or chemicals
- Choose breathable, well-fitting footwear to minimize trauma to toenails
- Maintain a balanced diet rich in biotin, protein, and other nutrients essential for nail health
- Stay hydrated to support overall skin and nail health
- Use moisturizer on nails and cuticles to prevent dryness and cracking
By incorporating these practices into your daily routine, you can significantly improve the health and appearance of your nails over time.
When should you consult a healthcare professional about nail concerns?
While many nail issues can be managed at home, certain symptoms warrant professional attention. Consider seeking medical advice if you experience:
- Persistent discoloration or changes in nail shape
- Pain, swelling, or redness around the nails
- Thickening or thinning of nails that doesn’t improve with home care
- Separation of the nail from the nail bed
- Signs of infection, such as pus or warmth around the nail
- Nail changes accompanied by other skin or health issues
Early intervention can often prevent minor nail problems from developing into more serious conditions. Don’t hesitate to consult a dermatologist or podiatrist if you have concerns about the health of your nails.
By understanding common nail conditions, their causes, and appropriate treatment strategies, you can take proactive steps to maintain healthy nails and address any issues that may arise. Remember that nail health is often reflective of overall health, so caring for your nails is an important aspect of your general well-being.
Nail diseases chart: Pictures, symptoms, and treatments
The following are diseases that commonly affect the nails:
Nail psoriasis
Nail psoriasis can cause nail denting or crumbling.
Causes
People living with psoriasis may develop symptoms. It occurs when psoriasis affects the skin of the nail bed or near the nail beds.
Symptoms
Potential symptoms include:
- crumbling nails
- pitting
- changes in color to yellow or brown
- a build-up of skin under the nails
- blood under the nails
- the nail separates from the bed
Treatments
People should talk to their doctor if they live with psoriasis and notice symptoms on their fingernails. Treatments may include:
- strong corticosteroid cream
- tazarotene, to treat pitting and discoloration
- calcipotriol, to treat build-up under the nail
- injections of corticosteroids
- laser treatment
Learn more about nail psoriasis here.
Brittle splitting nails
Brittle splitting nails, or onychoschizia, is a common issue that dermatologists see. The condition can cause brittle, soft, splitting, or thin nails.
Causes
Common causes of brittle nails are repeatedly wetting and drying the nails. Though less common, other causes may include iron deficiency or underlying illness.
Symptoms
The most common symptom is that the nails break easily. The American Osteopathic College of Dermatology state people can often tell if the cause is internal, as the condition affects both fingernails and toenails. If there is an external cause, symptoms will typically only affect the fingernails.
Treatments
The most common remedy is for people to use moisturizer, and keep the nails protected from chemicals and repeated exposure to water.
Onychogryphosis
Onychogryphosis is a condition where the nail becomes overgrown and thick, often affecting the big toe. It can cause one portion of the nail to grow longer than the other part.
Causes
Potential causes of onychogryphosis include:
- genetics
- injury
- circulation issues
- psoriasis
- ichthyosis
Symptoms
When a person has onychogryphosis, the nail grows very thick. In other cases, a portion of the nail may grow larger than the other part. The growth can resemble a ram’s horn, so people often refer to it as Ram’s horn nails.
Treatments
A person will likely need to see a podiatrist or dermatologist, to help cut the nail. They may be able to show the person how to do this at home. People may need several trips to the doctor to cut it back and let it regrow. The only permanent treatment is the removal of the nail bed.
Ingrown toenails
An ingrown toenail can cause pain and swelling, and in some cases, they can become infected.
Causes
According to the American Academy of Orthopaedic Surgeons, genetics may play a role in the development of ingrown toenails. Also, there are other potential causes, including:
- not keeping nails trimmed
- wearing tight socks or shoes
- physical injury
Symptoms
Symptoms can include:
- swelling and tenderness
- redness
- soreness
- pus
Treatments
Treatments may include:
- surgery
- soaking the nail in warm water 3 to 4 times each day
- wearing comfortable shoes
- keeping the foot dry
- taking acetaminophen or ibuprofen for pain
Learn more about ingrown toenails here.
Nail fungal infections
Nail fungal infections are a common condition that causes the nails to become thick, discolored, and easier to break. Nail fungus is more common in the toes than fingers.
Causes
Several different types of molds and fungus can affect nails. They grow when a crack or break traps fungi between the nail and the nail bed.
Sweat, athlete’s foot, and salon manicures and pedicures can put people at higher risk of nail fungal infections.
Symptoms
Symptoms include:
- thick nails
- discolored nails that are brown, yellow or white
- fragile or cracked nails
Fungus under the nails often is not painful.
Treatments
Remedies typically involve the use of antifungal medication. People may need a prescription, or a doctor can fully remove the nail.
According to the Centers for Disease Control and Prevention (CDC), it can take more than a year for successful treatment.
Learn more about nail fungal infections.
Onycholysis
Onycholysis is when the toe or fingernail painlessly separates from the nail bed. It typically occurs slowly over time and could result from an underlying health condition or injury.
Causes
The most common cause is from local injury to the nail. Other triggers include:
- excessive filing
- exposure to chemicals
- allergic contact dermatitis
- submersion in water
Psoriasis, fungal infections, and reactions to certain medications are also common causes.
Symptoms
The main symptom of onycholysis is the separation of the nail from the nail bed. This can result in discoloration of the nail, turning it green, yellow, or opaque. It can also cause additional skin tissue under the nail, nail pitting, nail thickening, or bending of the nail edges.
Treatments
Management varies based on the exact cause of the onycholysis. Some potential treatments could include:
- treating psoriasis with oral or other medications
- treating iron deficiency
- oral antifungal treatments
Prevention is also important. Harvard Health Publishing recommend people take the following steps:
- keeping their nails trimmed
- using rubber gloves when submerging hands in water for long periods
- avoiding harsh chemicals
- treating underlying conditions
Learn more about onycholysis here.
Paronychia
Paronychia is an infection that causes redness and swelling around the edges of a nail bed.
Causes
There are two types of paronychia: acute and chronic. Acute paronychia occurs when there is an infection due to direct or indirect trauma to the cuticle or nail fold. Chronic paronychia is often the result of allergens or irritants.
Symptoms
Acute paronychia symptoms can include:
- swelling
- pain
- redness
- fever and gland pain in severe cases
- yellow pus
Chronic paronychia often starts on one nail and spreads to others. The nail folds may have the following symptoms:
- redness
- pain
- swelling
- yellow or green pus
- lifting of the nail from the bed
- tenderness
Treatments
Treatments vary based on the cause of the paronychia. For acute cases, the options may consist of:
- warm compresses
- topical antibiotics
- corticosteroids
- oral antibiotics
- surgical incision and drainage, in severe cases
To manage chronic paronychia, a doctor will typically treat the underlying cause of the inflammation. This can include avoiding allergens and irritants. Treatment can take several weeks to months.
Learn more about paronychia here.
People should talk to their doctor if they notice changes to their nails. A medical professional can diagnose the condition and recommend suitable treatment.
If someone undergoes treatment for a nail disease and there is no improvement, or new symptoms develop, they should seek medical advice.
Many diseases can affect the nails. Treatments typically involve preventing further nail damage and treating the underlying condition.
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Onychomykose
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Pilzinfektion des Bereichs zwischen den Zehen.
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Onychomykose-Nägel vor grauem Hintergrund
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Zehennagelpilz
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Hautdesinfektion, Kosmetikerin desinfiziert die Füße von Frauen mit dem Präparat
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Fuß mit beschädigten Nägeln dorsal, Kallus, Mais, wegen Pilz
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Green nail syndrome – causes, symptoms, treatment and prevention
August 06, 2021
Almost every one of us faced different problems with nails. Ribbing, delamination, discoloration are the most common of them. Often the nail turns green – this means that one of the infections has got into the nail plate: a virus, bacterium or fungus. The treatment in each case is different, so you need to “know the enemy by sight” and be able to fight him.
Causes of green nail syndrome
The most common causes of green nails are:
Traumatic injuries
As a result of microtrauma or bruising, blood accumulates under the nail, soaking the soft tissues. At first, the skin becomes purple-cyanotic, with time it becomes green, and then yellowish. This is a natural process that should not be interfered with. If the cause of the problem is an injury, over time, the nail plate will again acquire a uniform healthy shade.
Fungi of the subspecies Candida
They do not damage the nail plate itself, but parasitize under it, causing a whole range of unpleasant symptoms, including greening of the nail. The cause of infection is a weakened immune system, because this fungus in a small amount always lives on the mucous membranes of the body. When natural defenses fail, pathogens become active.
Fungi of the genus Aspergillus
They multiply on the surface of the nail, causing visible damage, discoloration and an unpleasant smell.
Bacterial infections
One of the most common pathogens is Pseudomonas aeruginosa. This is the most dangerous pathogen that can even lead to death, spreading throughout the body.
Pseudomonas aeruginosa or Pseudomonas – the most common “culprit” of green nails
Pseudomonas live in the external environment, the human body is in constant contact with them. In the case of a weakened immune system, pathogen cells are activated, which leads to the development of green nail syndrome and a number of other problems. When Pseudomonas enters the nail cavity, it begins to multiply, forming a greenish-blue pigment, as a result of which the nail plate turns marsh-green. Spots can occupy both the entire nail and part of it, localized on one or more fingers.
Pseudomonas aeruginosa develops in the nail plate in two ways:
- Only in the upper part. This is visible to the naked eye: green spots are located in the outer layers of the nail, without affecting the soft tissues and without being accompanied by other symptoms. A person has no pain, onycholysis. To fix the problem in this case, it is enough to cut off the top layer of the nail.
- Getting into deep soft layers under the plate. In this situation, in addition to greening, burning, itching, suppuration, exfoliation of the nail, and the spread of infection to the cuticle zone join the symptoms of the pathology. Bacteria multiply rapidly – it takes 2-3 days for Pseudomonas to get into the blood.
Causes of Pseudomonas getting into the nail plate
The fact that the bacterium is on the surface of a healthy nail will not turn green. In the vast majority of cases, Pseudomonas infection occurs when extended nails are detached and air pockets form under them. Once there, pathogen cells begin to multiply actively. The problem arises due to non-compliance with the technological conditions of extension:
- insufficient degreasing of the nail plate before the procedure;
- ignoring the application of a primer that provides a sufficient level of adhesion of natural and artificial nails;
- insufficient treatment of the nail with a buff, as a result of which areas with a natural shine remain on the plate;
- non-compliance with the technology of correction of extended nails and incomplete removal of the old layer of the nail, as a result of which air pockets remain in place, and a new layer of gel is simply “poured” from above.
Also, risk factors that can cause Pseudomonas aeruginosa to enter the nail plate are:
- Detachment of the nail, inflammation of the periungual fold, damage to the cuticle, destruction of the nail plate under the influence of external or internal factors.
- Prolonged exposure to moisture on the nail plate.
- Prolonged wearing of extended nails.
- Regular contact with aggressive chemicals, the ground without protective gloves.
- Permanent trauma to the nail plate.
- Contact with Pseudomonas aeruginosa carriers.
Pathology treatment methods
Elimination of the problem of green nails is carried out in two ways and depends on the stage of development of the pathology.
Superficial stage
If there are small superficial green spots on one or more nails of the client, proceed as follows:
- Treat hands with antiseptic.
- Remove the artificial material with a cutter or file to the natural nail plate. Here, the MAX manicure vacuum cleaner will be an excellent assistant – it does its job perfectly, protecting the master and the client from microparticles of harmful substances and materials getting into the lungs and eyes. The company manufactures professional accessories used by thousands of professionals around the world.
- Spread a paper towel or napkin on the table, file down the affected area with a disposable file to a healthy layer. If the client experiences pain, the manipulation must be stopped. The pain indicates that the pseudomonad has penetrated into the deep layers of the nail, and one cannot do without consulting a dermatologist.
- Throw away the file, napkin, treat the client’s hands and your own with an antiseptic.
- Take a cotton pad, moisten it with plenty of antiseptic, apply to the affected area.
- Additionally, you can treat the problem area with a slice of fresh lemon. Acid neutralizes Pseudomonas aeruginosa, and also neutralizes the remnants of green in the nail plate.
- After all disinfecting measures, it is necessary to apply an acid primer to the nail and wait for it to dry completely.
- Upon completion of the procedure, a new decorative coating can be applied in compliance with all antiseptic treatment measures and relevant technologies.
Some manufacturers produce preparations intended for salon treatment of nail plates affected by Pseudomonas. They have proven effectiveness, so experts recommend that all manicure masters acquire such tools.
Deep stage
Antibacterial treatment is indispensable in this case. It should be prescribed exclusively by a doctor – a person may have an individual intolerance to the drug. If the case is complex, both topical antibiotics and oral medications will be prescribed. The doctor will make the correct treatment and give recommendations that will make the therapy as effective as possible.
On average, drug treatment lasts 2-3 weeks. In advanced cases, therapy lasts up to 4 months. During this period, it is necessary to regularly visit a doctor who will monitor the dynamics of treatment, if necessary, adjust the prescribed drugs.
It is important to understand that green nail syndrome can be caused not only by bacteria, but also by fungi. That is why it is so important to contact a dermatologist – he will conduct an examination, take a nail sample for analysis, identify the cause of the development of the pathology, and then prescribe treatment. It is not recommended to purchase antifungal and antibacterial drugs on your own: they can not only be ineffective, but even harm the body.
Folk remedies
There are a number of folk remedies that will help you deal with Pseudomonas aeruginosa faster. It is recommended to use them in combination with medical treatment and only after prior consultation with a doctor:
Rubbing tea tree oil into the affected nail. The substance has a proven bactericidal effect.
Alcohol compresses. They quickly and effectively kill bacteria in the upper layers of the nail plate.
Vinegar bath, 1 tablespoon of acid in 250 ml of warm water. The procedure should be performed 4 times a day for 5 minutes.
Preventing nail problems
Treating green nail syndrome is not an easy task. Therefore, it is easier to follow the basic principle of preventive medicine and prevent the problem, rather than deal with it.
There are a number of general recommendations to help avoid fungal or bacterial infection of the skin and nail plate:
- Use only your own shoes and do not wear someone else’s, even at a party.
- Do not walk barefoot in public places – beaches, swimming pools, changing rooms, etc.
- A person struggling with Pseudomonas aeruginosa or fungal infection of the nail should not go home without shoes. He should also have his own hygiene products – towels, nail files, scissors.
- Wear comfortable footwear that will keep your feet from sweating.
- Regularly visit the manicurist and monitor the condition of the nails.
You should take a responsible approach to choosing a nail master. By themselves, healthy nails are a sufficient protective barrier to prevent bacteria and fungi from entering them. It is also recommended to regularly inspect the nail plates for visible changes – especially if a person constantly wears a decorative coating. In case of the slightest suspicion of the presence of Pseudomonas or other problems, you should contact a specialized medical specialist – a podiatrist or dermatologist.
Collection of material for sowing parasitic fungi in Khabarovsk
Taking material for sowing mushrooms with onychomycosis is an opportunity not only
to establish the fact of infection, but also to determine the type of pathogen. Analysis
helps to distinguish nail fungus from other diseases with similar
symptoms, but also to determine the type of onychomycosis, the correct treatment regimen.
The fact is that drugs that treat yeast often
ineffective against dermatomycetes and vice versa. About the features of the procedure
a Podiatry Lab specialist will tell you.
What is onychomycosis
Spores are introduced into the nail plates, gradually along it
spread, go into the deep layers of the skin, can get into
blood flow. The fungus has the following effect on the nails:
- destroys collagen – a protein that holds cells together, makes nails
durable; - damages keratin, the protein that makes up nails;
- inhibits immune reactions, which allows the fungus to resist
immunity; - produces substances that contribute to the appearance of corns and
hyperkeratosis; - reduces local immunity, which often leads to reproduction
papillomaviruses, the formation of warts on the soles.
What does onychomycosis look like
What do parasitic fungi cause
Nail fungus (onychomycosis) is a highly contagious disease.
You can infect your feet if you walk barefoot on the floor in
public places (pool, sauna, etc.), use someone else’s
shoes, towel, nail scissors. His triggers are
yeast-like fungi Candida, dermatomycetes, filamentous
non-dermatomycetes.
Complications of onychomycosis
It is important to detect and treat the disease in time. On one’s own
onychomycosis will not disappear. Fungi penetrate the nail plate and begin
destroy her. Nails change color, deform, thicken. They
become brittle, irregularities, cracks, furrows appear.
Over time, the nail plates begin to crumble, peel off, poorly
regrow due to damaged matrix. Periungual ridges, area in
area of the matrix becomes inflamed. If the immune system is weak, as well as against the background
endocrine diseases mycosis is able to spread throughout the body.
Why choose PodiatryLab?
Cost of services
Qualification of doctors
Choice of services
Nail fungus visual
Laboratory diagnostics
Diagnosis of onychomycosis is based on:
- Clinic physical symptoms
- Microscopy – examination of a sample of infected tissue under
microscope. The procedure helps to determine the presence of fungus - Cultural research – sampling of material for sowing with isolation
fungal culture to determine the type of pathogen
What material is used for inoculation
A piece of infected nail and skin is taken for analysis:
Distal subungual form. For research, they take not only a piece
infected nail, but also material from under it, from the nail bed.
They also capture the area of the unchanged nail plate, since on
border with the damaged area of the nail are the most active pathogens
matrix where it is formed) – a nail biopsy is performed when
taking a sample of the skin under the nail
How to prepare for the examination
To avoid false results, to the sampling of material for sowing mushrooms
you need to prepare properly:
- Antimycotics (tablets, creams) should not be taken before the procedure. If
this was done, the collection of material is transferred – for 4-7 days with
using an ointment, for 2-4 weeks when using systemic drugs
(tablets) - The day before the test, do not wash your fingers with antibacterial and
disinfectants - If there is varnish on the nails, remove it a few days before the procedure
How the procedure works
Before doing a cultural study, microscopy is prescribed,
which will determine the presence of the pathogen. If the diagnosis is confirmed or
doctor doubts as a result of microscopy, Podyatry Lab specialist
inoculates the material on a standard Sabouraud medium.
Collection of material for analysis
A Podyatry Lab specialist uses a scalpel to scrape off the top layer of the epithelium or nail plates. Nippers can be used to take a sample of the nail. The material is placed in a test tube filled with saline. The sample is delivered to the laboratory for testing.
Microscopy
- Tissue samples (pieces of the nail, subungual layers) are placed in
centrifuge tube - A 15-20% solution of potassium hydroxide (KOH) or hydroxide is poured into the container
sodium (NaOH) - The tube is left overnight at room temperature
- Sediment is captured with a special pipette and transferred to a subject
glass - The sample is covered with a coverslip and viewed under a microscope.
- If the tissue is infected with a fungus, the specialist detects mycelium in the form
threads – thick, thin, branched, even, etc. Under a microscope
budding spores or budding mycelium are also visible - To determine the type of fungus, sowing on a nutrient medium is prescribed.
Fungal inoculation
Direct microscopy can give both false positive and
false negative results. Moreover, it cannot be used
determine the type of fungus. Therefore, cultural
research – sowing the material on a standard Saburo medium.
The nutrient medium is rich in substances that are necessary for growth
bacteria and fungi – vitamins, carbohydrates, amino acids, minerals
salts. Antibiotics are often added (cycloheximide, penicillin,
streptomycin), which improve the isolation of pathogens, inhibit the growth
mushrooms that penetrate from the air. Some mushrooms do not grow with
cycloheximide, therefore, two options for sowing are done: with this antibiotic
and without it.
The procedure consists of 3 steps. Let’s consider each separately.
Preparation of culture medium
The culture medium is supplied in a special vial. Specialist:
- Loosen the lid and heat the container in a water bath for 45
minutes - Closes the lid and stirs the contents
- Flask for 15 sec. left at room temperature, then
transferred to a thermostatically controlled water bath, which maintains
temperature 45-50°С - This is where the vial will remain until use
- Before sowing, its contents are mixed and poured into bowls.
Inoculation and incubation
Samples are placed in the bowl immediately after scraping. Fungal growth is
at a temperature of 30 ° C. Incubation time depends on the type of fungus.
Some types of molds, including dermatophytes, grow slowly
– 2-3 weeks.
Getting results
When the incubation ends, the specialist evaluates the results.
The determination of the microorganism is carried out using a microscopic
studies of the grown culture or reseeding on selective media.
The author of this article:
Pryanishnikov Roman Vyacheslavovich
Traumatologist-orthopedist, chief physician of the PodiatryLab clinic
Operative PodiatryLab
Indications
- Suspected onychomycosis
- Yellow, brown color of the nail plate
- Deformation of the nail (cracks, furrows, thinning)
- Thickening of the nail plate
- Chipping of the nail plate
- Stains, stripes on the nails
- Separation of the nail plate from the bed
- Increased fragility of nails
9028 5 Inflammation of tissues around the nail
Contraindications
- Internal or external use of antimycotics before the procedure
- Treatment of nails with antibacterial agents for several hours of sampling for culture
Possible test results
According to the cultural study, the dermatologist determines the type
pathogen and prescribe treatment.