The percentage of diseases with mycosis of the feet is approximately 15-18% of the total population.Among nail pathologies, onychomycosis - fungal infections - represent 30%.The main cause of the disease is infection with 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 age of the patient, the general state of 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 approximately 80-95% of all cases) and occasionally molds and yeast-like fungi.
Toenail damage can be caused by:
- Trichophyton rubrum.
- Interdigital T.
- Anthropophilic Trichophyton.
- Mold fungi.
Mold affects the toenails of people between the ages of 50 and 70.Nail mycosis is likely to occur due to a mixture of fungi.
There are different forms of onychomycosis:
- Normotrophic (with preservation of the normal configuration of the nails).
- Hypertrophic (subungual hyperkeratosis contributes to the 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.
According to the localization of the process, the nail fungus of the lower extremities is classified into distal (free edge of the nail), lateral (lateral sides), distal-lateral form, proximal (the back cushion 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, a pink tint and a shiny appearance.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 the color and shape of the nail plate;
- surface dulling, roughness, delamination;
- thickening or thinning of the plaque.
When the disease occurs, one nail is affected or the infection spreads to nearby nails.Possible manifestations: itching of the skin, peeling near the nail plate.
Symptoms of toenail fungus, depending on the pathogen, are given in the table:
| Stimulus | Demonstrations | Peculiarities |
| T. rubrum | Yellow spots, longitudinal stripes along the lateral edges of the nails | In children it manifests itself with superficial roughness |
| Interdigital T | Spots, yellow stripes in the thickness of the central part.Plate deformation.Thickening of the free edge | The shape of the lesion is normotrophic |
| Anthropophilic Trichophyton | Gray stripes and spots on the lateral parts and distal edge.Thickening of the plaque, appearance of furrows, fragility | With favus, the disease begins with the appearance of a yellow spot in the thickness of the nail plate, which gradually spreads across the entire plane.The toenails are affected during the prolonged course of the disease |
| Molds | The lesion is superficial.Possible color of the nail plate: yellow, greenish, blue, brown, black shades |
Manifestations of onychomycosis, depending on the form of damage to the nail plate:
| Name | Symptoms | Coloring |
| Normotrophic | The shape and shine are preserved.The nails thicken at the corners | Yellow distal edge, opaque surface |
| Hypertrophic | Growth of subungual hyperkeratosis.Thickening over the entire surface, loss of shine.Transverse stripes, deformed plaques.Surface loosening occurs at the free edge.Some patients experience pain when walking | The initial phase is characterized by a yellowish color that changes to dirty grey |
| Atrophic | Significant deformation and destruction of the plates;partial exposure of the nail bed;stratification of loose and crumbling horny masses | Opaque, color: dirty gray or yellowish |
| By type of onycholysis | Thinning of the plates, separation from the bed, loss of brightness | Opaque, yellow, gray appearance with a dirty tint.At the base of the nail the color is preserved |
A patient may experience different forms of toenail fungus.
Reasons
The main source of infection is dermatophytes.
Onychomycosis infection on the feet is likely:
- at home through household items (bath mat, washcloth, towel, slippers, socks);
- when wearing tight shoes for a long time (especially made of synthetic materials);
- in the sauna, in the bathhouse, in the swimming pool, in the shower, in the gym.
Flakes of pathogens from patients suffering from mycosis of the feet fall onto the floor, grates, benches and objects.High humidity favors the development and proliferation of fungal infections.
The causes of nail fungus depend on the type and how it penetrates the nail plate.Trichophyton rubrum infection occurs from the affected skin of the feet.The superficial white fungus Trichophyton mentagrophytes appears as a result of softening of the nail plate, which has been left 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 the pedicure;
- tendency to excessive sweating of the feet;
- decreased immunity;
- nail injuries;
- diabetes mellitus;
- impaired blood supply to the lower limbs.
Toenail fungus may be diagnosed in people who take corticosteroids, antibiotics, or immunosuppressive therapy for a long time.
Treatment
When choosing a method of therapy, it is necessary to take into account the type of lesion, 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: No more than 50% of the plaque surface is affected, the matrix is affected and not all toenails.
The most effective topical drugs in the form of ointments, creams and solutions.
If individual nails are affected, it is recommended to soften the plaques at home with any preparation with keralitic effect, remove the infected areas and then apply creams or solutions.Along with nail treatment, smooth skin therapy is performed.
Systemic treatment
Used when local therapy is ineffective, multiple lesions of the nail.
Drugs of choice include:
- Itraconazole
- Fluconazole.
- Griseofulvina.
- Terbinafine.
The course of treatment will be more effective if the stratum corneum and affected areas are first removed.The procedure will also shorten the overall treatment time.
Traditional methods
When the disease is mild and in the initial stage, it makes sense to use folk medicinal remedies.
Usage:
- baths (herbal, salt, soda, vinegar, potassium permanganate);
- lubricating nail plates with propolis tincture, birch tar, iodine;
- compresses and pastes made from a mixture of onion, soda and garlic.
Home remedies are available and treatment is inexpensive.
Characteristics 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 manifestations of fungus are detected in children in school or kindergarten, it is necessary to carry out a regular examination of the child's feet.
Treatment during childhood requires the use of safe products as prescribed by the doctor.An important stage of therapy is adhering to hygiene and carrying out antifungal treatment of shoes.
When treating adults, strict compliance with the instructions for the use of drugs is required, taking into account contraindications and possible side effects.