Fungal infections

  General of the foundation structure:
Nail grows directly from the cuticle (epidermis) and is composed of several layers of protein called keratin horny. Keratin is also a fundamental component of the outer layer of the hair and skin. Nail no living cells and grow out from a group of specialized cells called intercellular (matrix) has many blood vessels under the nail halo (lunular). Nail semicircular halo, white, very clear looking at the thumb. When the intercellular layer intact, the nails do not grow out of. Unlike bone, calcium did not affect the growth of the nail.

 

In the fourth month of pregnancy, the fetus has begun nails on the toes fingers. Nails grow continuously throughout life, not like the hair grows at five, pause for a while to grow.
Here are the characteristics of the nail grows
- Nails grow towards the fingers, toes, and not like the hair standing erect. It is caused by a skin surrounding the nail bed, which limits the growth forward.
- Each day approximately 0.1 mm long nails ie from 3 to 5 mm per month. Fingernails grow faster than toenails to 2 or 3 times. The time required and sufficient to replace an entire nail is <6 months.
- Nails grow slowly in the elderly, growing faster in pregnant women, men and young people.
- Long finger nails grow faster in the short fingers, might as easily injured. Therefore middle finger nails grow fast, while the thumb nails grow slowly.
- Nails grow faster in hands upon, or used, because blood put to much.
- In the summer, nails grow faster than winter, because summer limbs in movement, to much blood. Similarly, in the daytime, nails grow faster at night.
- The minor injury to the nail, such as nail biting nails will stimulate healing, so the nails grow faster. Similar to the continuous rubbing, skin cell layers will create solid cylinders.
- Malnutrition, fever, severe illness will delay the growth of the nail.
- Nails grow faster in patients with hyperthyroidism patients.
- Fingers typing on computer keyboards, typewriters, piano keys are stimulated nails grow faster.
- When the dead are no longer nails continue to grow, contrary to what some people mistakenly, in fact, because the skin at the base of the nail to nail people die shrink nom seems a little longer.
Nam nail: A chronic disease and often deformed nails. The nail fungal infection often irregular uniform or symmetrical and often found infected in one or two nails. Onychomycosis is the destruction of the nails, pins (but rarely all) caused by fungal infection.
Nails or more because the shoe tight wet nails done and this is a favorable environment for fungal growth. In contrast, workers in the hands frequent contact with water such as selling soft drinks, seafood workers, housewives ... then nail or more.
Fungal infections are often difficult to treat, requiring longer treatment period of 12-18 months and relapsing disease. Easy nail fungus toenail fungus treatment over. The nail fungus treatments have side effects, so there must be a specialist dermatology examination, specify and monitor treatment. Even when all nail fungus treatment, the disease can recur even after discontinuation of anti-fungal medication for a short time. So topical antifungal medication may be used to maintain after anti-fungal medication.
Nguyen's
- Mold (Seopulariopsis, Hendersonula ...)
- Grain yeast fungus (Candida albicans): vulnerability is the deformation on the surface of the nail, the surface becomes rough, rugged lost normal smooth draw, could have played a lot of dirt covered. Another important feature is the damage from the shore tendencies carried out freely and around nails red swelling, pus, very painful squeeze.
- Do fungal filaments (dermatophytes): lesions on the surface of the nail fungal particles like men, but starting from the shore and into the freedom of tendencies and usually no inflammation around the nails.
Cach transmission
Onychomycosis usually appear on the nail was injured earlier. These injuries usually vi nail injury, tight shoe.
It can be spread from person to person because the fungus can survive in moist air, land should go barefoot vulnerable people. Fungal infections can also occur in the bathroom, shower, dressing room or when manicure, nail clippers with people with onychomycosis.
Onychomycosis is a common disease in people who work regularly in contact with water such as housework, cleaning the pool, room service, who sells soft drinks, car wash, breeding, selling shrimp fish ... Those sweating when working or playing sports. Persons with a history of fungal limbs, groin fungus, manicure, pedicure, people> 65 years of age, medical disease, limb ischemia, diabetes, immunodeficiency (HIV / AIDS)
  The clinical manifestations:
Onychomycosis is often no symptoms but mostly special nail polish loss, brittle and too deep. Quality nails can dry and even foam. These pieces are not infected nail may break. To confirm the diagnosis should check under the microscope to see if the group branched hyphae and spores are not. Destroy damaged nail disease ugly, sometimes purulent, pain affects productivity. Another feature is easy to recognize the disease on a hand, foot injuries do not always happen on every nail. There are the following symptoms:
- Nail fungal infection will have the following signs:
Foundation brown, yellow or white spots, may be black
Foundation brittle, brittle, flaky, pockmarked
-Increase The horn under the nail
Foul odor
Thick foundation and shoe pain
Bear cake, making it difficult to travel, work
- The surface was roughened nails, covered with a fine layer of bran flakes, with horizontal or vertical striper. The vulnerability yellowish, brown or black.
- Beneath the nail can also hurt and peeling nails.
- Seldom all ten fingernails or toenails were ten patients. On each nail, vulnerability to attack from the shore on and no inflammation around the nail (if due to dermatophytes) or from the original foundation go out and have inflammation around the nails (if due to Candida).
- When the inflammation around the nail is very painful, red and swollen with pus
Infection in the lower part of the nail and distal (DLSO: Distal subungual onychomycosis and lateral), is the most common form of nail dystrophy, often due to dermatophyte fungi, sometimes more fungal infections (Mould) phat.Trang things on nail surface (SWO: Supperficial white onychomycosis), is a form characterized by the dermatophyte Trichophyton mentagrophytes infection, often unpopular. At the base under foundation (PSO: Proximal subungual onychomycosis). Derived from the close of the nail and is usually secondary to chronic inflammation around the nails by the yeast Candida. Full nail dystrophy (TDO: Total dystrophic onychomycosis), the final shape of the entire nail dystrophy foundations be destroyed as a result of the above three types of infection.
  Diagnosis of onychomycosis.
- Often used to nail one, after a time spread to other nails.
- Often from the shores of freedom (outer) spread into.
- Initially the white spots later to slowly, gradually thickened nails, white, friable as core drying. Long nails were eating parrots 1/3 -2/3.
- You can add rustic black fungus in the groin, buttocks, hands, feet.
- Testing positive for fungi.
  Differential Diagnosis
Manicure: In addition to skin lesions, eczema can also cause damage to the nail, sometimes there are some cases of eczema in nails without skin lesions. In indigo nail, usually all the nails were. Nail surface roughness with horizontal stripes, with small holes like termites were eating, around the nail has eczema and itchy lesions. Treatment: as treating eczema.
Nail psoriasis. In psoriatic lesions are very common foundation can in 80% of cases. Deformed nails, peeling up, the surface has small holes, depressions visible spot, spots change color with vertical stripes or white spots and take the ball around the nail is rough due to hyperkeratosis. Nail thick white but sometimes difficult to make reliable, psoriatic skin, nails and was 10 once.
Deformed nails drug when used Fluorouracil cancer treatment can make peeling nails (onycholyse). This is a manifestation of the sun-sensitive drug. Using synthetic antimalarial drugs to treat AIDS and zidovudine can nail brown.
Nail diseases caused by systemic disease.
The types
- Yellow nail syndrome: crooked nails, nails yellow. Cause: aging in men, consistent lymphatic, respiratory infections, chronic sinusitis.
- Nail lanes have vertical stripes, lightweight, spoke of the anemia.
- Nail crater in iron deficiency.
- Thyroid Disease: peeling nails, thickening.
- Acute bacterial round forward: often in patients who do farms. Inflammation around the nail pedicure red swelling, pus. If damaged nails from the nail root outwards.
- Inflammation around the nail fungal Candia albicans: women often have inflamed vulva, vagina by Candia. Red swelling around the nail inflammation, pus. Broken nails from the inside out. Soi transplanted Albians Candia.
  Treatment:
  Topical drugs:
- Group azole (ketoconazole, clotrimazole, miconazole, sulconazole, oxiconazole, Econazole).
- Ciclopirox Olamine.
- Amorolfine (loceryl).
- Group allylamine (natifine, terbinafine).
- Group acids (salicylic, undecylenic).
- Groups polyenes (nystatin).
If the patient only 1 or 2 lesions, just use anti-fungal topical (cream, liquid, paint) on the spot as the dye solution Castellani, salicylic acid 5%, or use one of the following topical cream or pommade Ketoconazole, Clotrimazole, fluconazole, itraconazole, terbinafine, Canesten, Trosyd, Exoderil, Naftin etc ..
How to apply: After washing and shaved spot lesions nails, nail ointment to the surface and around the nail, 2-3 times per day, for at least 3 months.
However, most of these preparations have little effect on fungal nails, even when used in combination with nail withdrawal, due to limited permeability of the excipients in the foundation. Therefore, treatment with oral currently selected more.
  Oral medications: Use anti-fungal drugs based on 3 criteria
+ Spectrum of antifungal effects.
+ The pharmacokinetics of the drug.
Clinical Manifestations.
You can use: Griseofulvine (only works on fungal filaments), Ketoconazole, Clotrimazole, fluconazole, itraconazole, terbinafine, ... (have an effect on both fungi) but must be specified and directed by a health specialist. Your doctor may use additional anti-inflammatory drugs, antihistamines, or antibiotics if there is other symptoms.
During the antifungal drug, the patient should be limited or preferably away from wine, beer and other alcoholic beverages as would cause a negative impact on the liver.
- Itraconazole:
· Continuous: 200 mg / day, in 6-12 weeks
· Treatment of intermittent: 400 mg / day in the first week / month within 2-3 months. Intermittent treatment regimen with oral itraconazole 200 mg 2 times a day for a week, and each session separated by 3 weeks (phase 2 for the treatment of nail fungus treatment and 3 phase for toenail fungus) for high efficiency has been confirmed by numerous clinical studies.
- Terbinafine: 250 mg / day (6-12 weeks). (250mg per day for 3 months) and bring success, but there are sporadic cases of failure, particularly when mixed fungal infections.
- Fluconazole: 150 - 400 mg per week, from 6-12 months. Fluconazole (150mg once a week until healing), seems attractive, but even with doses of 450 mg per week for 9 consecutive months just to clean mushrooms rate is 60%.
- Griseofulvin (only works on fungal filaments): 0.5 - 1 g / day (6-12 months).
First Month 2 tablets / day x30ngay.
Second month: Take a date
The third month: Week 2 drinks a day.
The following month: Week 1 day drinking
- Methods of preservation foundation: high heels white spot acne until the specified method for incipient cases of illness. Daily soak nails in warm water illness special soap. Rinse, dry nails, tape antifungal and horny as alcohol consumption Iodine 10%, salicylic fat, fat Arievic
- Method withdraw surgical anesthesia nails, nail splitting knife sick from foundations and organizations around the nail and then clamp to draw red nails.
Pros: expedited
* Disadvantages: pain, bleeding, complications from surgery, trauma mần manicure nail grows out to be bad, still surviving fungal recurrence.
Thoi treatment time
It usually takes at least from 3- 6 months to 12 months of cases, the time required to fully replace the new foundation. Onychomycosis is a disease but not dangerous but unhygienic, aesthetic and very difficult to treat. So we need to treat early and correct method.
.Du prevention of fungal infections
- Keep hands, feet always dry and clean by wearing rubber gloves when in contact with water. Avoid soaking hands and feet for a long time under water. After working in water, wash clean, dry hands, feet right
- Do not use a damp cloth, do not share it with others.
- Replace, socks every day. Do not wear socks, socks from day to day. Should choose socks with breathable fabric and hygroscopic. Sweaty feet are helping to facilitate the type of bacteria and fungi proliferate.
- Always manicured fingernails, toenails carefully, steadily, according to the shape of the finger-toe, should not be too long. Do not use the tool-foot nail trimming, limiting crop, trim, paint or soaked in nail salons.
Maritime cooperation Wash hands, feet carefully and wipe dry immediately after washing. Avoid contact with many soaps and chemicals.
- Treatment as soon as possible.
- If any persistent disease despite treatment should be changed if there is other work conditions.
  Note
Most of the injuries are from the nail salon. The nail file is not the right way to do the furry tip. In this situation, bacterial-fungal condition easily penetrate causing onychomycosis, nail damage.
Often the girls nails used to fill defects in real nails (by the way always posed as paint, attach "reliefs"). Nails are really tied up with glue or nails "cement" in particular, the need to be peeled off using neutral solution binder. Use detergent dry nail nails frequently. These chemicals irritate the skin around the nail inflammation, itching, allergies and more gold manicure, thinning, loss of detachment and loss of protective coating nails and nutritional disorders. For people with sensitive skin, the use of some chemicals to line nail, nail polish also irritate the surrounding skin. When nail polish, apply artificial nails, nail need to have time off because if done continuously for a long time will cause degeneration of the nail.
Folds in the skin of the nail with one tiny crawling up on the nail plate called the epidermis (Cuticle). This is a very important task of preventing water, chemicals or germs from entering the folds in and tendencies. Unfortunately the nail workers or those who have the habit of nail Khuoi or scrape off, some chemical solution to cleanse the skin and nails have lost protective cuticle. When manicure, hand dipped in water to soften the nails long and prone to fungal nail infection or spread of disease by not cleaning tools. For those who have the habit of nail polish, nail, it is best to equip a manicure kits separately to avoid contamination of infectious diseases.
In addition, the appearance of the symptoms of onychomycosis, nail care disorders, atopic dermatitis caused by exposure to chemicals .. as above, the majority of patients are often self-treated by topical medications that contain corticosteroids , rub lemon, long nails soaked in water wash. The improper treatment will nail infection more severe and spread to other nails. Despite what reasons, the treatment is very long, lasting 3-6 months. In addition, patients need to keep your hands dry, not exposed to chemicals, soaps and patient compliance to treatment.