Introduction
Fungal infections of the nail are very common among individuals. Dermatologists often see patients with nail infections. Many people visit their primary care physician or receive a referral to a dermatologist because they feel their nail issue is caused by a fungal infection. However, it is not necessary that all nail infections are fungal. But the majority of nail infections are caused by fungus. One of the nail fungal infections is called tinea unguium. It is somewhat similar to onychomycosis (fungal infection of nails). However, there is a difference between tinea unguium and onychomycosis.
According to researchers, "onychomycosis" should include nail infections caused by any fungus, including dermatophytes, mold, and yeast, while "tinea unguium" should be limited to dermatophyte-induced nail infections. Dermatophytes are pathogenic fungi that cause infection on the skin, nails, and hair. This article will emphasize tinea unguium.
What Is Tinea Unguium?
Tinea unguium is a dermatophyte infection that affects nails. According to studies, Tinea unguium is a prevalent fungal infection that accounts for 15 percent of all nail abnormalities. In contrast, dermatophytosis accounts for ten percent of all patients with fungal infections of the nails. The specific feature of dermatophytes is that they typically infect sound and healthy nails. However, dystrophic nails, which are more common in elderly people, may also be invaded by them.
What Are the Causes of Tinea Unguium?
The primary causative agents of tinea unguium are Trichophyton rubrum and Trichophyton interdigitale. These are dermatophytes, and they consume the protein keratin, which is present in the fingernails and toenails. These keratin are important because they make the nails hard.
As discussed above, the fungus is the cause of tinea unguium. On the nails, numerous kinds of fungus can develop. But tinea unguium frequently attacks the toenails. The spread is possible from one nail to another. Tinea unguium is more prone to develop in those who:
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Possess a different fungus infection, like an athlete's foot.
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Have perspiring feet.
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Share nail clippers with someone who has a fungal illness.
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Frequently go swimming.
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In wet environments, such as locker rooms, walk barefoot.
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Utilize public or community restrooms.
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Put on fake nails.
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Have weak immunity.
Additionally, studies have shown that males are more likely than women to have tinea unguium because they wear closed shoes and are more likely to have occupations and lifestyles that can predispose to this infection.
What Are the Symptoms of Tinea Unguium?
The severity of the infection can affect the symptoms of tinea unguium. The nail's surface may become rough or uneven, and it may initially seem yellowish, brownish, or pale. The nail may thicken, turn discolored, may have chalky white spots, and even split from the nail bed as the infection worsens. In extreme circumstances, the nail may shatter or become malformed, which can be painful. The skin around the diseased nail may occasionally swell and itch. Apart from this, under the nail, there can be crumbling white or colored substances. The skin under the nail, or the nail bed, may get infected with the fungus if it is not treated.
How Is Tinea Unguium Diagnosed?
Tinea unguium is typically diagnosed based on how the nail and skin around it look. To confirm the presence of fungi, the doctor may take a sample of the diseased nail and send it to a laboratory for culture or microscopic investigation. It is crucial to differentiate tinea unguium from other nail disorders like psoriasis or trauma, which can manifest similarly to tinea unguium
To differentiate tinea unguium from other infections, taking a sample from the affected nail and sending it to a lab for a culture test and microscopic analysis is the gold standard. A definitive diagnosis can only be made if the culture test results are available because only the presence of mycelium under the microscope may not suggest a dermatophyte as the causal agent. Any dermatophyte that has been cultured from a nail is regarded as a causative pathogen and needs to be treated.
How Is Tinea Unguium Treated?
The severity of the infection and the underlying cause will determine how tinea unguium is treated. Topical antifungal drugs, such as creams, ointments, or nail lacquers, can be used to treat tinea unguium in mild cases. To guarantee total eradication of the fungi, these treatments may need to be administered for several months and can be applied directly to the diseased nail and surrounding skin.
Oral antifungal drugs such as Terbinafine, Itraconazole, or Fluconazole may be administered for tinea unguium cases that are more severe. These drugs are taken orally for several weeks or months. In certain circumstances, surgical excision of the afflicted nail may be required to allow topical drugs to be applied directly to the nail bed. The nail will grow back over several months after this treatment, which is typically performed under local anesthetic. The fungus can be eliminated using a specific sort of laser pointed at the nail itself.
However, If anyone experiences any of these symptoms, they should get in touch with the physician straight away:
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Pain that worsens.
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Symptoms that either do not improve or worsen.
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The appearance of unusual symptoms.
In addition, tinea unguium may be cured if treated properly. But, as the nail grows, it can take several months. Even after therapy, it is possible that tinea unguium frequently recurs.
How Is Tinea Unguium Prevented?
The best method of avoiding tinea unguium is prevention. The risk of infection can be decreased by following good hygiene measures such as often washing hands and feet, maintaining dry and clean nails, and avoiding being barefoot in public areas. Also, it is critical to wear comfortable footwear with proper ventilation and to refrain from sharing private belongings like towels, socks, and shoes.
Conclusion
Both the patient's dexterity and the cosmetic appearance of the nails are impacted by tinea unguium. It acts as a point of entry for bacterial infection into the patient's skin and may even help the dermatophyte infection spread to the skin and nails of other community members. Therefore, individuals should identify the risk factors and try to prevent this infection by taking all the preventive measures.
