Therapy goals Improvement of the symptomatology Elimination of pathogens Therapy recommendation The foundation of any onychomycosis therapy is local (“topical”) therapy: In type 1 infection (nail covered), the infected nail mass must first be removed so that topical antifungals (local antifungals/antifungal agents) can find their way into the nail bed. This is not required for … Nail Fungus (Onychomycosis): Drug Therapy
To prevent onychomycosis (nail fungus), attention must be paid to reducing individual risk factors. Behavioral risk factors Use of public bathing facilities Home bathing (as far as family members are the source of infection). Shoes too tight; plastic socks Preventive measures Advice on footwear: Avoid tight, closed shoes and rubber boots. Avoiding heat accumulation with … Nail Fungus (Onychomycosis): Prevention
The following symptoms and complaints may indicate onychomycosis (nail fungus): Yellowish discoloration of the nail Onycholysis – detachment of the nail plate. Grooving in the area of the nail plate Subungual hyperkeratosis – cornification disorder occurring under a fingernail or toenail. Thickened nails Deformed nails Decay of the nail Note: An exclusive clinical diagnosis of … Nail Fungus (Onychomycosis): Symptoms, Complaints, Signs
Pathogenesis (development of disease) Onychomycosis is an infection of the nail apparatus caused by dermatophytes, yeasts, or molds. Onychomycosis (nail fungus) is caused by Trichophytum rubrum (91%) in most cases. Much rarer are Trichophyton interdigitale (7.7 %], Epidermophyton floccosum or Microsporum species. Trichophytes exclusively affect the skin, hair and/or nails, as they can digest human … Nail Fungus (Onychomycosis): Causes
The anamnesis (medical history) represents an important component in the diagnosis of onychomycosis (nail fungus). Family history Are there frequent fungal infections in your family? Social anamnesis Current medical history/systemic history (somatic and psychological complaints). What changes have you noticed in the feet? (e.g., yellowing of the nail, thickened or deformed nails, detachment of the … Nail Fungus (Onychomycosis): Medical History
Skin and subcutaneous (L00-L99). Atopic eczema (neurodermatitis). Chronic nail dystrophies – nail formation disorders that may be congenital (dysplasia and malformation syndromes) or acquired Eczema nails Vascular skin changes due to arterial or venous circulatory disorders. Lichen ruber (nodular lichen) of the nail organ – chronic inflammatory disease of the skin / mucosa. Nail psoriasis … Nail Fungus (Onychomycosis): Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by onychomycosis (nail fungus): Infectious and parasitic diseases (A00-B99). Foot infection caused by bacteria such as erysipelas. Mycosis (fungal infection) of other parts of the body such as in the groin region
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; furthermore: Inspection (viewing) of the nails on the hands and feet, but also of the entire body, since mycosis (fungal infection) may also affect other areas of the body, such as the … Nail Fungus (Onychomycosis): Examination
Laboratory parameters 1st order obligatory laboratory tests. Microscopic fungal detection from the marginal area of the altered skin site/nail (native preparation). Cultural cultivation from the marginal area of the altered skin site. Histological examination in cases of suspected tinea unguium, but negative native preparation and negative culture.
General measures Observance of the general hygiene measures! Advice on the hands: Careful hand care After washing hands, use of a moisturizing skin care product (e.g., urea-containing hand care products). Wearing gloves during wet work Keep fingernails short Avoiding trauma Biting or manipulation of the nails Too frequent traumatizing manicure of hands (and feet) Advice … Nail Fungus (Onychomycosis): Therapy
