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Fungal Nails (cont.)

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What are the symptoms and signs of fungal nails?

There are many species of fungi that can affect nails. By far the most common, however, is called Trichophyton rubrum. This type of fungus has a tendency to infect the skin (known as a dermatophyte) and manifests in the following specific ways.

  • Starts at the ends of the nails and raises the nail up: This is called "distal subungal onychomycosis." It is the most common type of fungal infection of the nails (90%). It is more common in the toes than the fingers. Risk factors include older age, swimming, athlete's foot, psoriasis, diabetes, family members with the infection, or a suppressed immune system. It usually starts as a discolored area at a corner of the big toe and slowly spreads toward the cuticle. Eventually the toenails will become thickened and flaky. Sometimes, you can also see athlete's foot in between the toes or skin peeling on the sole of the foot.
  • Starts at the base of the nail and raises the nail up: It is called "proximal subungal onychomycosis." This is the least common type of fungal nail (3%). It is similar to the distal type, but it starts at the cuticle (base of the nail) and slowly spreads toward the nail tip. This type almost always occurs in people with a damaged immune system.
  • Yeast onychomycosis: This type is caused by a yeast called Candida and not by the Trichophyton fungus named above. It is more common in fingernails and may be the most common cause of fungal fingernails. Candida can cause yellow, brown, white, or thickened nails. Some people who have this infection also have yeast in their mouth or have a chronic paronychia (see above) that is also infected with yeast.

How are fungal nails diagnosed?

Physical exam alone has been shown to be an unreliable method of diagnosing fungal nails. There are so many conditions that can make nails look damaged, that even doctors have a difficult time. Therefore, laboratory testing is almost always indicated. A nail sample is obtained either by clipping the toenail or by drilling a hole in the nail. That piece of nail is sent to a lab where it can by stained, cultured, or tested by PCR (the best test but new and not widely available) to identify the presence of fungus. Staining and culturing can take up to six weeks to get a result, but PCR, if available, can be done in about one day. Most of the medications used to treat nail fungus have side effects, so you want to make sure of what you are treating.

Medically Reviewed by a Doctor on 3/26/2014

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Fungal Nails - Treatments Question: What treatment did you use for your fungal nails?
Fungal Nails - Signs and Symptoms Question: What did your nails look like when you had a nail fungus? What were your signs and symptoms?
Fungal Nails - Prevention Question: If you've had a toenail fungus, how do you try to prevent it from recurring?
Fungal Nails - Diagnosis Question: Why did you go to a doctor for your nail fungus? How was the condition diagnosed?
Source: MedicineNet.com
http://www.medicinenet.com/fungal_nails/article.htm

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