onychomycosis, fried a means by dermatophytes, yeasts and
non-dermatophytes fungus (the fungus) infection caused by deck, deck
gray become thickened and dull, or uneven, or A broken incomplete
disease. The incidence of fungal nail disease accounted for 2% of a
natural population of 5%, accounting for 30% of fungal skin
infections. Children's Nail rare fungal disease, the elderly more
common in the 40-60 year-olds is 15% -20%. Nail fungal infection of
the disease and climate (temperature, humidity), shoes, trauma,
self-immunity, genetic factors, and other related health conditions.
Etiology: onychomycosis pathogens are dermatophytes accounted for
first, followed by yeasts and molds. Many fungi can cause the disease,
dermatophytes are also due to regional differences in different
bacteria. Due to the different climatic conditions throughout its
incidence are not the same, an average of 9.1% of foreign and domestic
an average of 15%, Hong Kong residents toe nail fungal disease was 17%
~ 21%. It accounts for superficial fungal disease in 30% of the total
foot disease by 50%.
Recent discovery of dermatophytes and yeast mixed infections accounted
for 10% -20%, mixed infection of dermatophytes with the mold 4% ~ 17%,
yeasts and molds mixed infection of 15%.
Clinical manifestations of nail fungus disease clinical manifestations
of the deck turbid, thick, rugged surface, discoloration, deck
destruction, impairment or loss, tilt, and paronychia. There are
divided into two types: superficial type and a lower type; is usually
divided into the following four types:
1. Distal lateral subungual type is one of the most common type.
Common bacterial pathogens in red hair to be Trichophyton fungus,
Ashland hair fungus, Candida albicans, Candida parapsilosis, short and
capitals Scopulariopsis sp. A first invasive pathogens distal nail bed
under, and from this invasion, and a lower deck. A first cause
cortical destruction, a bed horny hyperplasia, thickening, turbid
deck, deck color. A remote damage the edge of an irregular, pigment
changes may be distal to the proximal nail bed spread was at band. As
the deck thickness, can be formed deck warpage, or cause a separation.
A remote deck of longer duration are missing, crisp, fall off a rugged
proximal residues.
2. Proximal subungual type this type common in patients with immune
deficiencies, such as HIV infection, leprosy patients. Pathogenic
bacteria mainly for red hair, but also for Candida albicans,
Epidermophyton floccosum, Ashland hair bacteria. A pathogenic bacteria
invade the roots of the deck and a small skin and proximal nail bed,
the deck appears cloudy, thickened, rough rugged and so on, often
accompanied by paronychia.
Superficial white type 3 by the required majority of infections caused
by Trichophyton, but also for Candida albicans, peach microspore
fungus, Cephalosporium, Fusarium and Aspergillus, etc.. A direct
violation of the deck surface for the bacteria, early lesions less
than 1mm white islands, expanding and blended them into a white cloudy
cloudy, uneven deck surface or deformation can also be collapsed.
A four-wide malnutrition type: by the above-mentioned three lesion
aggravated evolved. Full deck erosion, damage, loss, nail scratching
the surface of the accumulation of keratin hyperplasia.
Diagnosis: The diagnosis of nail fungal disease based on clinical
manifestations and mycological examination (microscopy and culture),
and sometimes to do multiple checks to determine. The disease needs to
and the following A Disease Identification:
1. Psoriatic A disease: the head, trunk or limb with psoriatic skin
lesions, the deck of a thimble, there is a separation, a thickening, a
turbidity, color, etc. A change in negative fungal examination.
2. A Lichen Planus: Lichen planus may be violations of the deck,
forming the deck deformation, deck shrinking, according to the body
skin lesions, the deck changes and negative fungal examination can be
identified.
3. Chronic eczema: eczema-like other parts of the body changes, and
often invaded and palms and soles, pointed toes, deck gray, with
vertical and horizontal ridge groove, fungi examination negative.
4. A White syndrome: the performance of similar superficial white nail
fungus disease, but the surface is smooth, white cloud-like changes
seen in the deck, the fungus examination negative.
5. A thick congenital disease: a family history, childhood disease,
deck thickening, opacity, but the deck is smooth, negative fungal
examination.
Treatment: Nail fungus relatively refractory disease, treatment for a
long time because of a slow growth, deck thickness, less than a direct
role in bacterial drug, obtained good results, be sure to adhere to
treatment interruption, the deck to try to scrape thin.
1, local drug: A little applied to disease, damage, or pulling a small
range of A can be used as auxiliary treatment after the application.
And internal medicine when there is a contraindication choice.
Adherence to treatment can cure more than 50%.
1) simple external application
(1) 30% acetic acid solution or 10% iodine tincture for external use:
Start out the disease before treatment is best Xiu A, the more
thorough the better, so that a direct role in bacterial liquid. Before
each subsequent drug Zaigua look, adhere to more than 6 months. To
protect a surrounding skin. Can also be soaked in vinegar eating
disease A, 30 minutes a day, stick to cure.
(2) Bate Fen (8% ciclopirox olamine A agents): Daily topical once a
medication for 16 weeks straight nails, nail 24 weeks.
(3), amorolfine (5% amorolfine A system of Liu): external use once a
week, continuous in June.
(4) quinoline itraconazole (including 28% of quinoline itraconazole
formulations A): once a day topical, sustained in June.
2), surgical and chemical addition to pulling A A
(I) Surgery pull A: application of a single fungal infection of the
disease A, pulling a short-term after taking the antifungal drug,
while a bed to clean up the liquid or partially coated. Can improve
the cure rate.
(2) Chemical addition to A: Available 40% urea ointment, mycophenolate
g PCS (1% biphenyl and 40% urea Festival wow ointment), and stripping
A cream and so on. Deck after the removal of the liquid for external
use at best.
Superficial white nail fungus, simply scrape disease A, topical
anti-fungal agent therapy.
2, the system medication: for people with various diseases A and
accompanied by other skin ringworm, or 1-2 months after a long illness
A drug for treatment or those who pull a treat unhealed. Except for
contraindications. Be chosen according to the following drugs: adhere
to medication cure rates of up to 90%.
(1), itraconazole, wow: At present, to use more shock therapy. Each
200mg, day, two times, the middle, or after a meal of rice Dayton
clothes, even clothes l weeks after 3 weeks as a course of treatment
withdrawal. Nail infections take 2-3 months treatment, nail treatment
required 3-4 months.
(2) terbinafine; to dermatophytes infection of choice, for some yeast
and mold and effective. Patients in general usage as follows: 250mg
once daily after a meal or clothes, and even changed every other day
for 1 week after medication 250mg, continuous medication 4-6 weeks
(fingernails) or 4-12 weeks (toenail).
(3) of fluconazole: the dermatophytes and Candida A illnesses. In
recent years, found that drug resistant strains of Candida increased
medication means medication a week once a dose of 150 ~ 300mg,
medication for 12 weeks in patients with fingernail, toenail 16 ~ 36
weeks.
Following the above method cure for nail fungus disease, but also
re-infection or recurrence, we must adopt the following preventive
measures to avoid recurrence.
To prevent a. Improve the body's immune function. 2. Improvement means
that the toe blood circulation, to avoid Chuanxiao Xie. 3. Active
treatment of common diseases of the hand, foot and ringworm. Part 4 to
avoid the trauma. 5. To develop good health habits, do not wear other
people's shoes and socks, do not other people's towels, bath towels,
do not share it with others basin, tub. 6, scheduled preventive
coating antifungal foot every 3 - 4 weeks time. Year in and year.
No comments:
Post a Comment