The fungus of the nails (onychomycosis) on the legs is a disease that has developed due to the damage to the plates of nails with mushrooms with dermatophytes (up to 96%), less often molds and yeast (about 4%).The infection diffuses more often from the skin of the feet with long mycosis existing on the legs.Here finds favorable conditions for development: increased humidity and nutrients.Under the influence of pathogens, the structure is disturbed and the color of the nail plates changes.Over time, their complete destruction occurs.
Onychomycosis is not only a cosmetic defect, but also a serious disease, which is subject to timely detection and adequate treatment under the supervision of a dermatologist.
The mushroom on the legs is recorded in millions of people in the world.About 5% of the total population suffers from onychomicosis.The disease is most widely common in people from 50 to 60 years.Every second person is sick in this age group.The treatment of pathology is difficult for them due to the presence of somatic pathology, mainly vascular and endocrine.Men are more often sick than women.Elderly people get sick more often than young people.Children rarely suffer, mainly affected by serious diseases.With AIDS, the disease has an atypical picture.
The causal agents of the Onychomicosis
The cause of the onyicomicosis on the legs are different types of mushrooms: dermatophytes, yeast mushrooms or mold separately or in combinations.
- Dermatophytes mushrooms represent up to 90% of all onychomycosis.They are represented by the mushrooms of the genus Trichophyton (most of the time T. Rubrum and T.Ir) Var. Interdigital).Very often, the nails plates on the legs are affected by Trichophophyton Rubrum.Dermatophytes are common in countries with a temperate climate.
- The mushrooms similar to the yeast of the genus candid on the onhomicosis on the legs rarely cause.They represent about 3% of the whole onychomicosis.In addition to Candida Albicans, also mushrooms such as S. Tropicalis, S. Parapsilosis and S. GuillierMondii cause the disease.
- Most mold mushrooms are unable to cause nails for nails alone.Only some of their species are independent pathogens: these are Scitalidium Ialinum and S. Dimidiatum (Nattrassia Magniferee), which are not less than in pathogenicity to dermatophytes.The onychomycosis on the legs is a lot of molds such as Scopularopsis Brevicoulis, Aspergillus spp., Pyrenochaeta Unguis-Heominis, Alternaria SPP., Fusarium spp.Et al.The infection is more common in countries with a warm and humid - tropic and subtropic climate.
Epidemiology of the disease
Most icomicosis is an anthropopphile infection.They are sick and spread infections mainly.
Dermatophytes mushrooms
The tank and source of dermatophytes mushrooms are a sick person whose pathogens are transmitted with direct contact or his personal things.The infection almost always extends to the nails on the legs with the feet concerned, whose disease proceeds both in clear and in secret (deleted of forms of mycosis).The risk of infection repeatedly increases in the presence of a disease in one of the family members.
The mushrooms are transmitted through infected shoes, clothes, files and nitchines for nails, carpet, linen, towel, cloth, etc.The transmission of the infection occurs when the common bathroom, the shower, the sauna, the swimming pool, the gyms and the beaches.He contributes to the entrance of mushrooms on his feet walking barefoot in the common areas.Pathogens live for a long time on wooden floors and floors.
Mushrooms similar to yeast
Mushrooms similar to the yeast of the candid genre are saprophytic flora and always live on a person's skin.A good immune system is retained by the growth of pathogens.Prolonged intake of antibiotics, contraceptives, glucocorticoids and cytostatics, endocrine pathology (often diabetes mellitus) and a series of diseases that exhaust the immune system.Explosive mushrooms penetrate the nails from the skin and mucous membranes of the patient or enter the human body with infected products rich in carbohydrates.
Molds
Mugs live in the ground.Their disputes fall on products, things and environmental objects.Nedimatophytes do not spread among people.
Risk factors for the development of the disease
For mushrooms, dermatophytes are characterized by a hereditary predisposition, male sex, elderly age, vascular diseases, diabetes mellitus, immunodeficiency states, increased sweating, nail injuries and presence of other dermatomicosis.
The mushroom infection similar to the yeast of the candid genre is characterized by a greater temperature and humidity, states of immunodeficiency, increased blood sugar, nail injuries and non -compliance with the rules of personal hygiene.
For the mold mushroom infection, serious states of immunodeficiency and nail injuries are characteristic.
Risk groups
The risk group on the development of onichomicosis includes:
- People who constantly use changing rooms, showers, saunas, etc.
- Professional athletes (swimmers, football players, athletes, etc.).
- Military personnel and other groups of people who use owners' shoes.
- Male faces.
- Age is over 60 years old.
Contribute to the development of the mushroom on the legs:
- Wear tight and strictly adjacent shoes.
- Increase in sweating or dry legs.
- Lessons and abrasions of nails, feet scratches, ingrown nails, etc.
- High and warm climate accommodation.
- Walk barefoot in public places.
- The presence of skin diseases in which the nail keratinization (psoriasis, ichthiosi) is interrupted.
- Diseases such as diabetes mellitus, states of immunodeficiency, circulatory disorders of the lower limbs, blood diseases, prolonged intake of corticosteroids, antibiotics and cytostatic.
- Genetic predisposition.
Development paths of the fleet mushrooms
There are several ways to penetrate mushrooms in the nail plate:
- Distal or distal-lameral (from the free or lateral edge).
- Superficial (directly through the nail plate).
- Proximal (subtyo -gut).
Distal-lameral path of mushroom penetration
The distal or distal penetration path is characteristic of the Trichophophyton Rubrum mushrooms.The pathogens are introduced into the nail plate from the free (distal) or in the side regions (lateral border).The main inflammatory process occurs in the nail bed, where improved cell proliferation occurs.The stingy layer of the skin on the free edge is thickened (hyperkeratosis), due to which the slab of nails raises and exfolia (onicolisi).
In addition, the infection spreads in the direction of the hole and penetrates the nail plate, which gradually (slowly) is destroyed.With damage to the matrix, the onychomicosis total dystrophic occurs.
The hyperkeratosis of the nail bed is observed in chronic eczema, psoriasis, warts, red dishes.
Surface path of the spread of mushrooms
Funghis Trichophyton Mentagrofori Var.The interdigital is more aggressive in relation to the horny structures of the nail plates than other dermatophytes.They mainly affect the external part of the nail plate, causing the development of the White surface icomicosis.The mushrooms under the influence of the enzymes of Keratinz pierce the layer of layer with Ife, gradually capturing all the layers of the nail plate.Mostly 1 and 5 fingers are interested.They are the ones who are subject to the largest shoe trauma when walking.1 and 4 intercal folds are affected in the disease.
The superficial form of onychomycosis is believed to be caused by fung-non-humanitophytes: acremonium spp., Fusarium oxysportum and some types of Aspergillus.
Path of distribution of proximal mushrooms
There is a third mushroom penetration route in a nail plate - through a nail roller next and a nail bed.The defeat begins with the skin in the nail roller area, which thickens and exfoliates from the surface of the nail.In addition, the final part of the matrix and the nail bed is involved in the process, with damage to which furrows, irregularities and cracks appear on the nail.With the penetration of pathogens in the nail plate, the nail acquires a white opaque color over time.Over time, the complete destruction and loss of the nail plate is noted.It is found more often in patients with HIV infection with the spread of infection through blood vessels.
Characteristics of the damage to yeast as the mushrooms of the candid genre
The damage to the mushrooms of the candid genre begins with a Parronica: inflammation of the proximal roller (located near the hole).You notice its edema and the thickening, which leads to the separation of the cuticle from the surface of the plate.In addition, mushrooms fall freely in the matrix and nail bed, causing, causing the nail from the tissues of the finger over time.
Characteristics of the damage to mushrooms by the incorporated
The damage to the nails with mushrooms with non -air -Iartofiti is secondary.Tabs (often Scitalidium spp.) Put in the nail already interested - cracks, space between the scallops of the nail bed or the desolate vessels.Subsequently, hyperkeratosis and slow destruction of the nail plate develops.
Clinical forms of onychomycosis on the legs
There are different forms of onychomycosis on the legs:
- Distal side.
- Superficial white.
- Proximal.
- Total dystrophic.
Distal lateral submarine on the legs on the legs
This form of the disease is the most common.In most cases, the cause of the Onyicomicosis is the dermatomicets, in particular Trichophophyton Rubrum.The pathogens penetrate the nail plate on the side of the free edge and the side edges.The hyperkeratosis of the perenophane develops, due to which there is a detachment of the nail from the tissues of the finger (onicolisi), loses transparency, acquires a white or yellow color, begins to crumble.With the development of the underwater hyperkeratosis, the nail plate seems thickened.With the progression of the disease, the focus of the lesion expands towards the hole, as indicated by the emerging stripes of yellow.Over time, the entire plate and matrix are involved in the pathological process, which over time leads to the dystrophy and the destruction of the nail.
In the elderly, the pronounced hyperkeratosis (thickening), the onyicogrifosis (thickening and deformation in the form of poultry claws) or coilonichia (concave deformation).Their nails are often influenced by mixed flora: dermatophytes, molds and even bacteria.
Surface shape (white) of onychomicosis on the legs
The onychomycosis of the white surface on the legs is the second largest form of damage distribution.His cause is mainly Trichophophyton Mentagophytes Var.Interdigitale, which penetrates the nail plate directly through its upper (pre -eal), as well as some types of mushrooms-non-ectophytes.Mostly affected by the nail on the first finger of the leg, less often - the fifth.
Initially, small white spots and stripes appear on their surface, which in the end fascinates a growing surface.Gradually, the color becomes yellow, ocher.The surface of the nail becomes loose, rough, dusty, it easily jumps away.There are no thickening and separation from the nail bed.
The proximal submarine form of onychomycosis on the legs
This form of mycosis is a rarity.It represents about 3% of the whole onychomicosis.The reason is the mushroom yeast by Candida Albicans and Trichophophyton Rubrum.The nail candidiasis is preceded by the inflammation of the permanent roller.He swells, acquires red, becomes brilliant.The cuticle is raised and the infection penetrates the final part of the matrix and the nail bed, when it is damaged by the wake, you can see irregularities and cracks on the nail plate, loss of natural brilliance and annoying.Gradually, the nail is destroyed, in serious cases it disappears.This form of onychomycosis on the legs is often found in patients with HIV infection.
Total dystrophic form of onychomycosis on the legs
This form of onychomycosis develops more often with a long -term disease (chronic path), whose cause are more often the mushrooms of Trichophophyton Rubrum and Candida Albicans.At the same time, the nail plate, the bed and the matrix are involved in the pathological process.The excuse of the nail occurs due to the development of the underwater hyperkeratosis.Over time, the nail plate is destroyed and the new one due to the matrix concerned does not grow or grow badly.
Types of damage to the nail plates
There are 3 options for onychomycosis:
- Normorophic.
- Hypertrophic.
- Atrophic.
Normototrophic type of onychomycosis on the legs
With a able -bot -type type, the infection is located in the upper layers of the nail plate.Its thickness and color in the disease do not change, but the points and stripes are visible in the depths.The color of the nails varies from white to saturated yellow.After some time, the spots and stripes come together.The damage area spreads to the entire nail plate, excluding the moon.The rupture and anger is not observed.Sometimes there is a slight loose of the free edge.With adequate treatment, a cure is possible.
Hypertrophic type of onychomycosis on the legs
This type of onychomycosis is the most common.As a result of the development of the underwater hyperkeratosis, the nail plate is significantly thickened, deformed and loses brilliance.The nails become irregular, opaque, acquire a gray-brownish color and crumble.The moon area is not interested.The disease gives the patient tangible discomfort.In elderly patients, the development of the icogogrifosis is observed: the nails thicken, stretch and bend themselves like an claw of a bird.
Atrophic type of onychomycosis on the legs
With an atrophic type (onicicitic), the nail plate quickly loses its connection from the nail bed, many voids appear in its layers, it fades, becomes more thin and changes in white or yellow-white.The surface remains smooth for a long time.Over time, a partial destruction occurs.
Signs and symptoms of the nail fungus
Very often, the change in the nail begins with a free (distal) or lateral (lateral) edge.
Change of color.With onychomycosis, a change in the color of the nail plate is the first sign of the disease.It becomes opaque, often loses shine, acquires a white or yellow color, with overlap with mold mushrooms: brown, brown, green and even black.
Inspiration.The increase in the number of horny masses following the development of the underwater hypercheratosis leads to the inspection of the nail.
Crush and destruction.In case of illness due to the vital activity of mushrooms, the nail plate crumbles and over time, over time, completely destroyed.
Characteristics of the damage to the nails with different types of onychomycosis
The damage to nails with different types of fungal diseases has its characteristics.The main types of pathogens are Trichophophyton Rubrum (70 - 90%) and Trichophophyton Mentagophytes V. Interdigital (8-30%).Candida Albicans, mold mushrooms, T. Mentagophytes V.Gypsum, T. Verrucosum, T. Tonsuras and T. VioLaceum, Epidermophyton Floccosum, Trichophyton are much less common.Schonleinii.
Onychomicosis on the legs with rubrofia
Rubbitics in the Russian Federation represent 70 and 90% of all mycosis.The feet in the disease are often influenced (usually a squamous dry type).An indispensable satellite of rubiliabilia of the feet is a nail fungus on the legs.With mycosis, the distal -iltal form of onychomycosis usually develops, the pronounced hyperkeratosis is characteristic, different fingers on the leg are affected simultaneously and often fingers on the one hand.The disease proceeds without special subjective sensations.More sore and discomfort when wearing shoes occur with pronounced hyperkeratosis, onicorifosis and an incarnated nail.The source of infection is often in the patient's family.
Associated onychomycosis are often recorded: Trichophophyton Rubrum and Candida Albicans, Trichophophyton Rubrum and molds.It is important to evaluate the cultural study.
Onychomicosis on the legs with t.Menughi Menagr.V. Interdigital
Mushrooms T. Mentagrophytes.V. Interdigital hits the skin of the feet and nails.Epidermophyososis represents 10-30% of all mycosis of the feet.
With the disease, the upper (dorsal) of the nail plate is interested.The superficial white form of onychomycosis usually develops.The pathological process is mainly involved in 1 and 5 fingers (they are subject to the largest trauma from the shoes during the walk) and 1 and 4 Inter -pack folds.The transmission of the infection occurs when using a common bathroom, in the shower, sauna, swimming pool, beaches and swimming pools.
Onychomicosis on the legs with damage to mushrooms similar to the yeast of the candid genre
This form of mycosis on the legs is a rarity.It represents less than 3% of the whole onychomicosis.Often the disease is recorded in people with chronic generalized candidiasis.The damage to the nails, as a rule, begins with the inflammation of the compliance roller located near the hole.You notice its edema and the thickening, which leads to the separation of the cuticle from the surface of the plate.In addition, the mushrooms fall freely in the matrix and in the bed of the nails (form of proximal sub-colpi), if grooves, irregularities and cracks appear on the nail, a loss of natural brilliance and clowning appear, a brown-brown-brown color is manifested.Gradually, the nail is destroyed, in serious cases it disappears.
Onychomicosis on the legs caused by molds
Plastic mushrooms are populated in a nail already hit - cracks, in the spaces between the scallops of the nail bed or the desolate vessels.Subsequently, hyperkeratosis develops and the slow destruction of the nail plate, which during the disease is colored in black (Scitalidium spp.) Or green or gray (Scopularopsis Brevicoulis).
Diagnosis of onychomycosis
The diagnosis of onychomycosis is based on the data of epidemiological history, the clinical picture of the disease and the data of the laboratory research method.
In a microscopic examination of the material, the nature of the disease is established (mushrooms or other pathogens).The identification of the mushrooms is established with a microbiological examination (crops of material on a nourishing medium) with the subsequent microscopy of a pure crop.The process is laborious, the success is achieved in half of the cases.The correct collection of material from the nails concerned is the key to a successful microbiological study.
Differential diagnosis
Only in half of the cases of patients with dermatologists with changes in the form and color of the nails produce fungal diseases.The onychomycosis should be distinguished from eczema, psoriasis, reitera syndrome, pachionichia, daria disease, flat lichen, Norwegian scabies, bacterial lesions.