The proportion of diseases with mycosis of the feet is approximately 15-18% of the total population.Among nail pathologies, onychomycosis (fungal infections) represents 30%.The main cause of the disease is infection by various types of dermatophytes.
Depending on the type of fungal infection, onychomycosis on the legs has different symptoms and first signs.The causes of the disease are influenced by many factors.Treatment depends on the complexity of the course, the patient's age, general health and includes both medical and traditional methods.
Characteristics of the disease.
Toenail fungus, or as it is also called, onychomycosis, belongs to a group of fungal diseases.The causative agents are dermatophytes (accounting for about 80 to 95% of all cases) and, occasionally, molds and yeast-like fungi.
Damage to toenails can be caused by:
- Trichophyton rubrum.
- T.interdigitale.
- Anthropophilic trichophytes.
- Mold fungi.
Mold affects the toenails of people between 50 and 70 years old.Nail mycosis is likely to occur as a result of a mixture of fungi.
There are several forms of onychomycosis:
- Normotrophic (with preservation of the normal configuration of the nails).
- Hypertrophic (subungual hyperkeratosis contributes to thickening of the nail plate over the entire surface).
- Atrophic (destruction of the nail plates occurs).
When affected by onycholysis, the plates separate from the nail bed.
Depending on the location of the process, nail fungus of the lower extremities is classified as distal (free edge of the nail), lateral (lateral sides), distal-lateral, proximal (the posterior pad is affected), total (the entire nail is infected) and superficial.
Signs
The symptoms of onychomycosis depend on the type of pathogen.A healthy human nail has a smooth surface and a pink tint and looks shiny.In most cases, the fungus spreads to the nail plate from the infected skin of the corresponding finger.
The first signs of onychomycosis:
- change in color and shape of the nail plate;
- surface tarnish, roughness, delamination;
- thickening or thinning of the plaque.
When the disease occurs, one nail is affected or the infection spreads to nearby ones.Possible manifestations: itching of the skin, peeling near the nail plate.
The symptoms of toenail fungus, depending on the pathogen, are shown in the table:
| Stimulus | Demonstrations | Peculiarities |
| T. rubrum | Yellow spots, longitudinal stripes along the lateral edges of the nail plates. | In children it is manifested by surface roughness. |
| Interdigital T. | Spots, yellow stripes in the thickness of the central part.Plate deformation.Free edge thickening | The shape of the lesion is normotrophic. |
| Anthropophilic trichophytes | Gray stripes and spots on the lateral parts and distal edge.Thickening of the plate, appearance of grooves, fragility. | With favus, the disease begins with the appearance of a yellow spot in the thickness of the nail plate, which gradually spreads to the entire plane.The toenails are affected during the long course of the disease. |
| Molds | The injury is superficial.Possible color of the nail plate: yellow, greenish, blue, brown shades, black. |
Manifestations of onychomycosis, depending on the form of damage to the nail plate:
| Name | Symptoms | Dye |
| normotrophic | Shape and shine are preserved.The nail plates thicken at the corners. | Yellow distal edge, opaque surface |
| hypertrophic | Growth of subungual hyperkeratosis.Thickening throughout the plane, loss of shine.Transverse stripes, deformed plates.At the free edge, loosening of the surface occurs.Some patients experience pain when walking. | The initial stage is characterized by a yellowish color that turns to dirty gray. |
| atrophic | Significant deformation and destruction of plates;partial exposure of the nail bed;layers of loose and crumbling horny masses | Opaque color: dirty gray or yellowish. |
| By type of onycholysis | Thinning of the plates, separation of the bed, loss of gloss. | Dull, yellow, gray appearance with dirty tint.The color is preserved at the base of the nail. |
A patient may experience different forms of toenail fungus.
Reasons
The main source of infection is dermatophytes.
Onychomycosis infection of the feet is likely to occur:
- at home through household items (bath mat, washcloth, towel, slippers, socks);
- when wearing tight shoes for a long time (especially those made of synthetic materials);
- in the sauna, bathhouse, swimming pool, shower, gym.
Pathogen flakes from patients with foot mycosis fall to the floor, railings, benches and objects.High humidity promotes the development and proliferation of fungal infections.
The causes of nail fungus depend on its type and how it penetrates the nail plate.Trichophyton rubrum infection occurs in the affected skin of the feet.The superficial white fungus Trichophyton mentagrophytes appears as a result of the softening of the nail plate, which has been in a humid environment for a long time.Tissue damage begins from above, a change in the surface is characterized by the formation of white lesions.
Other causes of the disease include:
- use of non-sterile instruments when performing pedicure;
- tendency to excessive sweating of the feet;
- decreased immunity;
- nail injuries;
- diabetes mellitus;
- disturbance of blood supply to the lower extremities.
Toenail fungus can be diagnosed in people who take corticosteroids, antibiotics, or immunosuppressive therapy for a long time.
Treatment
When choosing a method of therapy, one should take into account the type of injury, the degree of spread of the disease, the safety of the method, the general condition of the patient and the cost.
Treatment of toenail fungus is carried out using local therapy, folk remedies and systemic drugs.
Local therapy
Treatment is indicated for patients with distal, lateral and distal-lateral forms of onychomycosis.Condition: More than 50% of the plate area, matrix and not all toenails are affected.
The most effective topical medications in the form of ointments, creams and solutions.
If individual nails are affected, it is recommended to soften the plates at home with any preparation with a keralitic effect, remove infected areas, and then apply creams or solutions.Along with the treatment of nail plates, skin softening therapy is carried out.
Systemic treatment
It is used when local therapy is ineffective, multiple nail lesions.
Medications of choice include:
- itraconazole
- Fluconazole.
- Griseofulvin.
- Terbinafine.
The course of treatment will be more effective if the stratum corneum and affected areas are removed first.The procedure will also reduce the overall treatment time.
Traditional methods
When the disease is mild and in the initial stage, it makes sense to use medicinal folk remedies.
Wear:
- baths (herbs, salt, soda, vinegar, potassium permanganate);
- lubricate nail plates with tincture of propolis, birch tar, iodine;
- compresses and pastes made with a mixture of onion, soda and garlic.
Home remedies are available and treatment is inexpensive.
Features of therapy depending on age.
Treatment of onychomycosis on the legs differs in adults and children.If one of the family members has a disease or fungal manifestations are detected in school or kindergarten children, periodic examinations of the child's feet should be carried out.
Treatment in childhood requires the use of safe products prescribed by the doctor.An important stage of therapy is to comply with hygiene and carry out antifungal treatment on shoes.
In the treatment of adults, strict compliance with the instructions for use of drugs is required, taking into account contraindications and possible side effects.