Nail diseases

Onychomycosis is a nail infection that can be caused by various fungi (or fungi), among which the Candida albicans, Trichophyton Rubrum (the most frequent cause of interdigital forms), the Trichophyton mentagrophytes andEpidermophyton floccosum.
Once these pathogenic microorganisms penetrate the nail, they attack and feed on keratin, which is the main substance that the nail is composed of. The result is that the nail wears down and weakens.
The infection can affect both fingernails and toenails.Toenails are most at risk of onychomycosis, since the warm, humid environment created in shoes is fertile ground for the proliferation of these microorganisms."

Among the main risk factors that expose you to the onset of this infection, in addition to the use of non-breathable footwear, There are:

• Walking barefoot in hot/humid public environments, such as swimming pools and gym changing rooms.
• Excessive sweating.
• Too aggressive manicure/pedicure with the cuticle removal around the nail plate: if you remove the cuticle, which acts as a protective barrier against microorganisms, you facilitate the penetration of the fungus.
• Circulatory disorders
• Diabetes
• Advanced age.

Once the fungus has penetrated the nail, either from the lateral folds or from the free edge, the infection progresses rapidly, causing it to flake and peel off. appearance of white or yellow-greenish spots on the nail.

“Usually, the first sign of onychomycosis is the appearance of a small yellowish-white spot, or a darker color, on the edge of the nail plate, that is, the most superficial part.

Over time, this stain tends to spread until it involves the entire nail, which can end up detaching from the nail bed, that is, the pink part underneath, crumbling: in this case we speak of dystrophic onychomycosis.

Other symptoms of a fungal infection include:

• Thickening of the nail with subungual hyperkeratosis.
• Increased nail fragility.
• Unpleasant smell.
• Accumulation of materials formed by keratin residues under the nail.
• Pain in the ends of the fingers.

The infection usually starts on a nail, usually on the first toe, but later the other toes may also become involved.

Prevention of onychomycosis involves adopting some good practices such as:

• Dry your hands, feet and the space between your toes thoroughly..
• Do not walk barefoot in humid common areas.
• Prefer natural fiber socks.
• Give priority, when possible, open shoes.
• Avoid removing cuticles and do not use aggressive manicure products..
• Do not share towels with people who suffer from onychomycosis.

The first step, if you suspect you have onychomycosis, is to undergo a dermatological specialist visit.
“The dermatologist specialist, to complete the information gathered through the anamnesis and clinical examination, may request specific tests to confirm the diagnosis, that is, thedirect microscopic observation followed bycultural examination".

A piece of nail is removed Once detached from the nail bed, the nail bed is then scraped with a scalpel to remove the suspicious material. This sample is divided into two parts and subjected to two tests:

• The first is under the microscope to be able to observe any hyphae, or rather the fungal filaments up close, after having soaked the small piece of nail in 30-40% potassium hydroxide: already in this first phase it is possible to understand if you are dealing with a mycosis.
• The second test is performed by placing small pieces of nail on some plates containing culture media (to be clear, the classic transparent laboratory discs): if fungi are present, after 7-15 days colonies develop that appear as small spots of various shapes and colors that correspond to the different fungi.