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Onychomycosis
The nails of people with onychomycosis are initially a cosmetic concern. Without treatment, however, the nails can become so thick that they press against the inside of the shoes, causing pressure, irritation, and pain. Causes The primary fungi that cause onychomycosis are trichophyton rubrum and trichophyton mentagrophytes. They are dermatophytes (fungi that infect hair, skin, and nails) and feed on keratinized (nail) tissue. The infections they cause are normally confined to the nails, but occasionally spread to the surrounding skin. Another type of onychomycosis is caused by yeast (candida albicans or candida parapsilosis). These infections are less common and produce similar symptoms. Paronychia infections are caused by bacteria such as staphylococcus, streptococcus, and pseudomonas. In most cases, paronychia infections can be differentiated from onychomycosis by the inflammation they cause to the skin adjacent to the nail. Onychomycosis is difficult to treat. Medicines can be taken orally to kill these infections (e.g., Lamisil, Sporanox). Because the nail grows slowly, the medicine works gradually, requiring several months to completely eliminate the infection. In rare cases, these medications produce adverse side effects in the liver, so it is necessary for the patient to have a blood test to establish a liver enzyme baseline before starting treatment. After a few weeks, the test is repeated to check liver function and the medication may be adjusted or discontinued if necessary. Diabetic ComplicationsPatients with diabetes commonly develop onychomycosis because blood circulation is poor in the extremities, and the body's ability to fight infections is compromised. Small cuts, infections, and foot injuries can have serious consequences for diabetics. It is important to inspect the feet closely each day and work with a physician on a program of thorough foot care. |