Onychomycosis Flashcards
What is Onychomycosis
Fungal Infection of the nail plate caused by Dermatophytes, non dermatophytes and yeasts
What are Dermophytes
Pathogenic Fungus that can invade the nail infecting keratinous tissue
List three types of dermaphytes
Trichophyton
Epidermophyton
Microsporum
What are the most common Dermatophytes associated with Onychomycosis
Trichophyton Rubrum and Tricophyton Interdigitale
What are the non dermataphytes that cause Onychomycosis
Yeast - Scorpularis Brevicaulis
Moulds - Candida Albicans
What are the predisposing factors causing Onychmycosis
Old age
Trauma
Diabetes
Immunosupresed patients
Previous history of nail psoriasis and tinea pedis
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List the 5 types/ classifications of Onychomycosis
Endonyx
Distal & Lateral Subungal Onychomycosis
Superficial white Onychomycosis
Proximal Subungal Onychomycosis
Total Dytrophic Onychomycosis
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What are the features of Superficial White Onychomycosis
Mainly affects the toe nails
White patches on the superficial part of the toenail
Doesnt respond well to topical treatment
What are the features of Proximal subungal onychomycosis
- Area of infection Proximal nail fold and nail plate
- White appearance spreading distally
- dermaphytes involved commonly T - Rubrum
- No thickening of the nail plate
- High prevelance in HIV and Aids patients
What are the features of Endonyx Onychomycosis
- Caused by T Soudansense
- Area of infection = margian of the nail plate
- White in apperance no seperation of the nail from the nail bed (onycholysis) or no chalky substance underneath the nail (subungal Hyperkeratosis)
What are the clinical features of Onychmycosis
- Thickened Naill
- Crumbly Nial
- Rough/Irregular appearance
- Varying in colour white, yellow, brown black
- Can be painful but usually affects patient confidence due to apperance
Give the name of a topical anti fungal treantment used to treat Onychomycosis
Amoroline - Loycerel, Curanail
What is Total Nail Dystrophic Onychomycosis
- Infection of the whole nail plate
- Yellow irregular appearance causing total destruction of the nail
- Usually a cobination of Candida and dermatophytes
- Seen in immunosupressed patients
What are the conservative management treatments for onychmycosis
Conservattive - Topical treatments include:
* Amorolfine
* Terbinafine
* Triconazole
What are the Systemic oral treatments for Onychomycosis
Systemic - Oral treatments
* Grisofulvin - in children
* Terbinafine and Itraconazole
* Fluconazole - for Candida infection
