Onychomycosis

Onychomycosis is a dermatophytosis. These are fungi that attack the skin, hair, and nails. Mycosis of the skin and mucous membranes have a variegated appearance. We always think of fungal infection when itchy, mapped or garland-like areas begin to appear on the skin, which peels off at the periphery with a subjective feeling of healing in the center.

The most common fungal skin diseases affect the areas between the toes. Interdigital fungi in Europe affect up to 50% of adolescents. In addition to whitish horn scales, we can also see small cracks. Nail fungi (onychomycosis) of the feet and hands often follow the interdigital lesions.

The term onychomycosis also includes diseases caused by yeasts and opportunistic hyphomycetes.

1. Distal subungual type (most common)
   • It begins as onycholysis at the free edge of the nail and progresses towards the posterior nail wall, creating hyper-hyperkeratoses, thickening, deformation, and discoloration of the nail.
   • Etiology: T. rubrum.
2. Proximal subungual form (rare)
   • It starts from the posterior nail wall.
   • Etiology: opportunistic hyphomycetes.
     

     Onychomycosis
3. Surface white form (leukonychia mycotica) (rare)
   • In people with immunodeficiency.
   • Etiology: T. interdigitale or yeast.
4. Total dystrophic onychomycosis
   • Characteristic of chronic mucocutaneous candidiasis.

Therapy

• distal form - varnishes with antifungals,
• more than half of the nail is affected - systemic treatment,
• surgical removal of the nail plate is usually not performed,
• chemical ablation with keratolytic agents,
• disinfection of socks and shoes.

Links

Sources:

• GILLESPIE, SH a KB BAMFORD. Medical Microbiology and Infection at a Glance. 1. vydání. London : Blackwell Science, 2000. ISBN 978-1405111737.

• BERAN, GW a KB BAMFORD. Handbook of Zoonoses, Section A: Bacterial, Rickettsial, Chlamydial and Mycotic. 2. vydání. Florida : CRC Press, 1994. ISBN 978-0849332050.

• University of South Carolina. Microbiology and immunology online [online]. ©2007. Poslední revize 2009, [cit. 2009-12-07]. <http://www.sc.edu/study/colleges_schools/medicine/education/basic_science_departments/pathology_microbiology_and_immunology/index.php>.

• ŠTORK, Jiří, et al. Dermatovenerologie. 2. vydání. Praha : Galén, 2013. 502 s. ISBN 978-80-7262-898-8.

References

• SKOŘEPOVÁ, Magdalena. Klinické obrazy dermatomykóz. Interní medicína pro praxi [online]. 2003, roč. 5, no. 10, s. 11–14, dostupné také z <http://www.internimedicina.cz/artkey/int-200310-0015.php>. ISSN 1803-5256.