The proportion of diseases with mycoses of the feet is about 15–18% of the total population.Among nail pathologies, onychomycosis - fungal infections - accounts for 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 patient’s age, general 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 (account for about 80–95% of all cases), and occasionally molds and yeast-like fungi.
Damage to toenails can be caused by:
- Trichophyton rubrum.
- T.interdigitale.
- Anthropophilic trichophytons.
- Mold fungi.
Mold affects the toenails of people aged 50–70 years.Nail mycosis is likely to occur as a result of a mixture of fungi.
There are several forms of onychomycosis:
- Normotrophic (with preservation of the normal configuration of the nails).
- Hypertrophic (subungual hyperkeratosis contributes to thickening of the nail plate over the entire surface).
- Atrophic (destruction of the nail plates occurs).
When affected by onycholysis, the plates are separated from the nail bed.
According to the localization of the process, nail fungus on the lower extremities is classified into distal (free edge of the nail), lateral (lateral sides), distal-lateral form, proximal (posterior cushion is affected), total (the entire nail is infected) and superficial.
Signs
Symptoms of onychomycosis depend on the type of pathogen.A healthy human nail has a smooth surface and a pink tint and looks shiny.In most cases, the fungus spreads to the nail plate from infected skin on the corresponding finger.
The first signs of onychomycosis:
- change in nail plate color and shape;
- surface tarnishing, roughness, delamination;
- thickening or thinning of the plate.
When the disease occurs, one nail is affected, or the infection spreads to nearby ones.Possible manifestations: itching of the skin, peeling near the nail plate.
Symptoms of toenail fungus, depending on the pathogen, are shown in the table:
| Stimulus | Manifestations | Peculiarities |
| T. rubrum | Yellow spots, longitudinal stripes along the lateral edges of the nail plates | In children it is manifested by surface roughness |
| T.interdigitale | Spots, yellow stripes in the thickness of the central part.Plate deformation.Thickening of the free edge | The form of the lesion is normotrophic |
| Anthropophilic trichophytons | Stripes and spots of gray color on the lateral parts and at the distal edge.Thickening of the plate, appearance of grooves, fragility | With favus, the disease begins with the appearance of a yellow spot in the thickness of the nail plate, which gradually spreads to the entire plane.Toenails are affected during prolonged course of the disease |
| Molds | The lesion is superficial.Possible color of the nail plate: yellow, greenish, blue, brown shades, black |
Manifestations of onychomycosis, depending on the form of damage to the nail plate:
| Name | Symptoms | Coloring |
| Normotrophic | The shape and shine are preserved.The nail plates thicken at the corners | Yellow distal edge, dull surface |
| Hypertrophic | Growth of subungual hyperkeratosis.Thickening over the entire plane, loss of shine.Transverse stripes, deformed plates.At the free edge there is loosening of the surface.Some patients experience pain when walking | The initial stage is characterized by a yellowish color transitioning to dirty gray |
| Atrophic | Significant deformation and destruction of plates;partial exposure of the nail bed;layering of loose, crumbling horny masses | Dull, color - dirty gray or yellowish |
| By type of onycholysis | Thinning of the plates, separation from the bed, loss of shine | Dull appearance, yellow, gray with a dirty tint.At the base of the nail the color is preserved |
One patient may experience different forms of toenail fungus.
Reasons
The main source of infection is dermatophytes.
Infection with onychomycosis on the feet is likely:
- at home through household items (bathroom mat, washcloth, towel, slippers, socks);
- when wearing tight shoes for a long time (especially made of synthetic materials);
- in the sauna, bathhouse, swimming pool, shower, gym.
Scales of pathogens from patients with mycosis of the feet fall on the floor, gratings, benches, and objects.High humidity promotes the development and proliferation of fungal infections.
The causes of nail fungus depend on its type and how it penetrates the nail plate.Infection with Trichophyton rubrum occurs from the affected skin of the feet.Superficial white fungus Trichophyton mentagrophytes appears as a result of softening of the nail plate, which has been in a humid environment for a long time.Tissue damage begins from the top, 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 pedicure;
- tendency to excessive sweating of the feet;
- decreased immunity;
- nail injuries;
- diabetes mellitus;
- impaired blood supply to the lower extremities.
Toenail fungus can be diagnosed in people taking corticosteroids, antibiotics, or immunosuppressive therapy for a long time.
Treatment
When choosing a method of therapy, one should 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 plate area is affected, the matrix and not all toenails are affected.
The most effective topical medications in the form of ointments, creams, and solutions.
If single nails are affected, it is recommended to soften the plates at home with any preparation with a keralytic effect, remove the infected areas, and then apply creams or solutions.Along with the treatment of nail plates, smooth skin therapy is carried out.
Systemic treatment
Used when local therapy is ineffective, multiple nail lesions.
Drugs of choice include:
- Itraconazole
- Fluconazole.
- Griseofulvin.
- Terbinafine.
The course of treatment will be more effective if the stratum corneum and affected areas are first removed.The procedure will also reduce the overall treatment time.
Traditional methods
When the disease is mild and in the initial stage, it makes sense to use medicinal folk remedies.
Use:
- 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.
Features 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 from school or kindergarten, regular examination of the child’s feet should be performed.
Treatment in childhood requires the use of safe products as prescribed by the doctor.An important stage of therapy is to adhere to hygiene and carry out antifungal treatment of shoes.
When treating adults, strict adherence to the instructions for use of the drugs is required, taking into account contraindications and possible side effects.