Nail Fungus Infection

 09 Oktober 2018   

Nail Fungus Infection

Fungal infection of the toenails or fingernails could involve any component of the nail unit, including the matrix, bed, or plate. Can cause pain, discomfort, and disfigure of nail. May produce serious physical and occupational limitations

Usually without symptomatic , patients usually first present for cosmetic reasons without any physical complaints.

As the disease progresses may interfere with standing, walking, and exercising.

Patient nail plate shows colour changes which is usually yellow-white-green,  becomes roughened and crumbles , sometimes with inflammation around nail.

Patient may report nubness , pain, discomfort on toe / nail. They also may report loss of self-esteem.

Skin injury adjacent to the nail allow organisms to colonize, increasing the risk of infectious complications. Reports of complications include cellulitis, abcess,  osteomyelitis and tissue necrosis.

Laboratorium Test

with 20% potassium hydroxide (KOH) preparation and Cultur test will help to diagnose and specify the fungal species that cause the nail problems

Treatment

A combination of systemic and topical treatment increases the cure rate. Because the rate of recurrence remains high, the decision to treat should be made with a clear understanding of the cost and risks involved, as well as the risk of recurrence.

Some fungal nail infection need long oral tablet medication , that have side effects interfere liver function

To decrease the adverse effects and duration of oral therapy, topical treatments and nail avulsion may be combined with oral antifungal management. 

Removal of the nail plate should be considered an adjunctive treatment in patients undergoing oral therapy. A combination of oral, topical, and surgical therapy can increase efficacy and reduce cost.