Onychomycosis (tinea unguium) is a fungal infection of the nail bed, matrix or plate. Toenails are affected more often than finger-nails. Onychomycosis accounts for one third of integumentary fungal infections and one half of all nail disease. Tinea unguium occurs primarily in adults, most commonly after 60 years of age.
The incidence of this infection is probably fairly high. Occlusive footwear, locker room exposure and the dissemination of different strains of fungus worldwide have contributed to the increased incidence of onychomycosis. Tinea unguium is more than a cosmetic problem, although persons with this infection are often embarrassed about their nail disfigurement.
Because it can sometimes limit mobility, onychomycosis may indirectly decrease peripheral circulation, thereby worsening conditions such as venous stasis and diabetic foot ulcers. Fungal infections of the nails can also be spread to other areas of the body and, perhaps, to other persons. Dermatophytes, yeasts and nondermatophytic molds can infect the nails.
The clinical significance of molds is uncertain, because they may be colonizing organisms that are not truly pathogenic. The most common form of tinea unguium is distal subungual onychomycosis, which can also be distal and lateral. Distal subungual onychomycosis may develop in the toenails, fingernails or both. Some degree of tinea pedis is almost always present.
The infection is usually caused by Trichophyton rubrum, which invades the nail bed and the underside of the nail plate, beginning at the hyponychium and then migrating proximally through the underlying nail matrix. Susceptibility to distal superficial onychomycosis may occur in an autosomal dominant pattern within families.
White superficial onychomycosis accounts for only 10 percent of onychomycosis cases. The toenails are usually affected. White superficial onychomycosis is caused by certain fungi that directly invade the superficial layers of the nail plate and form well-delineated opaque “white islands” on the plate.
As the disease progresses, these patches coalesce to involve the entire nail plate. The nail becomes rough, soft and crumbly. The most common causative agent is Trichophyton mentagrophytes. Proximal subungual onychomycosis is the least common form of tinea unguium in healthy persons. Proximal subungual onychomycosis can also arise secondary to local trauma.
It occurs when the infecting organism, usuallyT. rubrum, invades the nail unit through the proximal nail fold, penetrates the newly formed nail plate and then migrates distally. Fingernails and toenails are equally affected. This form of onychomycosis usually occurs in immunocompromised persons and is considered a clinical marker of human immunodeficiency virus infection.
Patients with chronic mucocutaneous candidiasis may develop candidal infection of the nails. Candida species may invade nails previously damaged by infection or trauma. Candidal paronychia more commonly affects the hands and usually occurs in persons who frequently immerse their hands in water.
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About Author: staff of Nature Power Company, which is a network company dedicated to promoting customers' websites and developing softwares. You can go to the following websites to learn more about our natural organic products. http://www.bcured.net http://www.naturespharma.org
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