A fungal infection of the nail or onychomycois is more common with increasing age. It is often seen in men and individuals with circulatory problems or diabetes. Excessive wet work and warm sweaty conditions can contribute to infections of toe and fingernails. Untreated Tinea (ring worm) infections on the hands/feet and nail trauma can be precursors to infection.
Signs of a nail infection are;
- White or yellow discoloration
- Brittle, crumbly nails with jagged edges
- Thickening of the nail with separation from the nail bed
- Curling or distortion of shape
Patterns of infection of a nail vary and are as follows;
- Distil and lateral – involving the side and tip of the nail
- Superficial – white flaky patches on the surface
- Proximal – spots appear in half moon (Luna) area
- Subungual – scaling under the nail
- Complete nail destruction
The diagnosis of nail fungus is usually via clinical examination. This can be confirmed by nail clippings from the crumbly end of the nail being sent to the lab for culture and analysis.
Few infections respond to topical antifungal applications in practice. Oral antifungal treatment is usually required for 2 to 3 months. Infrared lasers are now being used successfully but are not available in Barbados. Removal of the nail is a desperate last resort.
Dr. Forde, B.Sc., M.B.B.S. (UWI); Dip. DERM. (LOND); FAAD,
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