Causes and risk factors
Dermatophytosis is caused by a group of fungi called as dermatophytes like trichophyton, microsporum and epidermophyton. Nail ringworm is cause by Trichophyton rubrum or Trichophyton interdigitale.The fungus is found in moist soil or warm areas like locker rooms or tanning beds or public showers. The nail fungal infection occurs due to overgrowth of the fungus in under or around the nails. Infection can be spread by coming in contact with the infected soil or by sharing personal items like clothing, hairbrush, towels, and sports goods. Touching or scratching or rubbing the skin with infected hands help in spread of infection to the area. Certain predisposing factors like diabetes and obesity also contribute to the causation. Use of contaminated tools for manicure and pedicure can also lead to nail infection.
Clinical presentation
The great toe nails along with the little toe nails are more commonly affected as the fungus usually thrives in dark and moist areas. Other finger nails can also be affected. The patient usually comes up with complaints of thickening and discoloration of nails. The nails become white or black or yellow in color. Pain on walking or pressures is experienced. The shine and luster of the nails is lost. They become fragile and easily break off. In most of the people it may become a psychological disturbance for cosmetic reasons. Infection if neglected can lead to spread to other areas.
Investigations
Diagnosis is confirmed on the basis of the symptoms narrated by the patient and on examining the nails. The affected area is seen under black light, glowing of the affected area in black light is diagnostic. Routine blood test and tissue cultures can also be advised.
Treatment
Administration of antifungal medications is the only line of treatment. Either oral administration or anti fungal ointments are prescribed. Along with this maintaining proper personal hygiene, avoiding sharing of personal items and use of foot wares near the swimming pool areas and locker room should also be implemented.
Other modes of treatment:
Certain other modes of treatment can also be helpful in coping up the symptom. Taking into consideration the symptoms in holistic way, homoeopathy can offer a good aid for the relief of the symptoms. The Ayurvedic system of medicine which uses herbs and synthetic derivates can also be beneficial in combating the complaints.