Nail fungus (onychomycosis) is a common disease that causes a number of pathogenic microorganisms. Depending on the localization, individual characteristics of a person and the characteristics of a particular parasite, the pathology differs in the course, external manifestations and other symptoms. There is no single classification of types of onychomycosis. The disease is divided into types according to various characteristics. The most common criteria are the location of the infection and the type of pathogen. To be able to distinguish a strain of fungus is very important, since the effectiveness of therapy and the further state of health of the patient depend on this.
Forms of the disease
Varieties of nail fungus are divided into four categories, which are characterized by a certain localization and penetration depth:
- Most people have a distal form. Infection begins to develop at the free edge of the nail plate. Its shade changes to gray, brown or yellow. As the infection spreads, the area with a pathological color will increase. This type of onychomycosis affects not only the appearance, but also the structure of the nail. The plates become rough, their stratification and gradual destruction are observed;
- The second common type is lateral. This fungus looks like a distal one. The difference is localization – foci are observed on the sides of the plate, and not on the edge;
- Less commonly diagnosed is a proximal form of the disease. The infection starts with a cuticle in which inflammation occurs. A small white spot is formed on the skin roller, gradually spreading along the plate. This leads to clouding, loss of gloss and destruction of the nail;
- The last known type is total. By name you can understand the description of this form. With total onychomycosis, the human nail is affected entirely.
The last two options (lateral and total) are found in people suffering from diseases of the immune system, such as HIV. If the pathology has reached severe stages, then a healthy patient will face a total form of fungal infection. In the absence of diseases of the immune system, a person meets with either a distal or lateral form of onychomycosis.
In the diagnosis, classification by the thickness of the nail can be applied. If there are no changes on this basis and the plate glistens, then this indicates a normotrophic form. With hypotrophic, the number of cells of the stratum corneum increases, there is a thickening of the nail (as in the photo below), which leads to discomfort while walking or performing household tasks. The atrophic appearance can be determined by the gray-brown color of the plates and their rejection from the bed. When a doctor encounters this form, he is 100% sure that he will not be able to save the nail.
Types of nail and foot fungus
Among the causative agents of onychomycosis, the most common is Trichophytone from dermatophyte fungi. However, the nail plates are sometimes affected by yeast and mold. Dermatophytes are also divided into several varieties:
- Trichophyton red. This microorganism causes onychomycosis of the hands and feet. You can suspect the onset of the disease by stripes and spots of white and yellow shades. In the absence of treatment, Trichophyton red affects the entire body, leading to the onset of rubromycosis. The causative agent is manifested by distal and lateral localization, which spreads atrophic or hypertrophic appearance;
- Trichophyton Mentagrophytes. The fungus develops in the spaces between the fingers and leads to the formation of cracks and expressions. Mentagrophytes passes to plates later. The moment of active reproduction of the infection is determined by the detection of yellow spots and hypertrophic keratosis. Some patients experience white areas on the little fingers or thumbs. The causative agent is especially active in hot periods;
- Favus fungus. It enters the body through microcracks on the skin, so the infection often occurs on the hands. On the plates, crusts of a yellow or brown hue are formed. As the pathogen spreads, an odor that resembles dampness begins to emit from the skin. This form of the disease was common only in North America;
- Flaky epidermophyton. The first signs of pathology are determined by peeling and itching of the skin of the fingers. The causative agent quickly captures healthy areas of soft tissues, leading to the formation of yellow spots, and then it passes to the keratin layer. A distinctive characteristic of the activity of the Flaky epidermophyton is a special nail atrophy. In the later stages, the fungus changes the plate so that it takes the form of a bird's beak.
Occasionally, a person may encounter a variety of pathogenic microflora called Trichophyton violet. Unlike the rest, this pathogen is less common and is found only in the Far East and Central Asia. The first symptom is trichophytosis of the head. As the disease develops, if left untreated, it spreads throughout the body and finally affects the nails. At this time, dark densified spots form on them – deformed keratin.
Among the most rare pathogens of onychomycosis such as dermatophytes, Geophilic microsporum stands out. To enter the human body, the fungus must first be in the body of the animal, where it penetrates from the soil. In the final host, the pathogen affects the scalp. If you do not notice the disease at this stage, later it will manifest on the hands.
Yeast and mold
Among yeast-like fungi, two types of pathogen are usually found: Candida white and Candida parapsilos. The first is localized on the hands, often being a secondary pathology against the background of already developed onychomycosis. Candida white spreads along the proximal region and atrophic type. A cuticle is affected in a person, with which pus begins to stand out. Pathology is characterized by severe pain.
The second type of yeast-like fungus concentrates on the edge of the plate. First, a black spot forms in this area, which grows with time. Without adequate treatment for Candida, parapsilosis leads to loss of the nail. In the case of mold pathogens, this is rarely observed.
Scopularis is the most famous type of mold. It accumulates under old wallpaper, affects the weakened toes or hands. This pathogen provokes the formation of white spots on the plate.
Black mold, also known as Aspergillus black, rarely parasitizes in humans, as this requires too much immunity. But if infection has occurred, then the patient on the nails will appear dark dots on the norotrophic type. Sometimes a complete staining of the plate is observed.
If a person with skin lesions comes into contact with crops, Fusarium may become infected. Although this pathogen is rare, it leads to a change in the color of the nail plate and its complete loss in a short time.
Diagnosis and treatment
Determining the type of pathology is necessary for the appointment of an effective medication. Since science knows more than fifty subspecies of pathogens, only a doctor can determine the pathogen accurately in the laboratory. At home, one or another form of fungus is suspected only at the beginning of the second degree of severity, since obvious symptoms develop at this particular time. At the early stage, only small spots and stripes appear, and at the neglected stage, there is an absolute loss of the nail.
After diagnosing and identifying the characteristics of the disease, the specialist will select the best medicines. Most modern antifungal drugs cover a wide range of pathogens. However, in order for the tool to accurately affect the parasite that has appeared, it is necessary to pass the appropriate tests. For effective therapy, it is recommended to combine local and systemic antimycotics. In the early stages, medicinal varnish is used for treatment, and antifungal tablets are useful for extensive lesions.
In the treatment of onychomycosis, hygiene is important. Before each procedure of applying varnish or therapeutic ointment, the legs or hands are steamed, and the diseased areas of the plates are cleaned with disposable files. Most patients take several months to recover, therefore it is better to prevent the development of the fungus than subsequently to treat it.