Archive for the ‘Fungal Infections’ Category
Joseph Bikowski, MD
Clinical Assistant Professor of Dermatology at Ohio State University in Columbus, OH.
Image: Filamentous Fungi (Dermatophytes) / MicrobeLibrary.org
Dermatophytoses are prevalent, prompting well over four million physician visits annually in the US.1 In the general population of the US, data suggest that onychomycosis is most common (23.2 percent of all dermatophytoses), followed by tinea corporis (20.4 percent), tinea pedis (18.8 percent), tinea capitis (15 percent), and tinea cruris (8.4 percent).1
Reliable recent data for disease prevalence among athletes are not available, though it seems from clinical experience that superficial cutaneous infections—tinea pedis, tinea cruris or “jock itch,” tinea corporis, tinea faciale, and tinea manus—are more common complaints among athletes than is onychomycosis. Read the rest of this entry »
By Richard Miller
Nail’n’Toe Founder Group
Ick! This is the normal reaction to the fungal toenail picture. Most people don’t want their toenails to look like this. The truth is: this is a picture of a moderately severe case. Discoloration, thickness, flaking, peeling… but not too bad!
A dermatophyte is a type of fungus which affects skin, hair and nails. You may be familiar with Digger the Dermatophyte from the horrifying commercial where Digger climbs under a toenail and makes a home with his buddies. But, Digger and the dermatophytes are not the only ones making homes, non-dermatophytes and yeast also can infect the toenails. The fungus causes the nails to first become slightly yellow or white and splotchy.
Later nails will thicken, and become very brittle. The shape begins to change and the discoloring can darken to deep brown. As the fungus worsens, the nails become thicker, more yellow or brown, more brittle (or sometimes much harder) and abnormally shaped.
About 30 million Americans are affected by toenail fungus. That is a lot of fungus! Men are twice as likely to develop fungus than women, athletes, seniors and the elderly are more at risk, those who have poor circulation or sweaty feet are more at risk, those with a compromised immune system are more at risk and those with poor hygiene and chronic foot fungus (athlete’s foot) are more likely to develop toenail fungus.
Dermatophytes are parasitic fungi that cause skin, hair and nail infections. Vividly portrayed by Digger the Dermatophyte in Lamisil commercials, these fungal spores look more like the ones in the picture to the left.
Dermatophytes are classified into three groups of fungus: Microsporum, Epidermophyton and Trichophyton. Each consists of about 40 known species of fungi.
These microorganisms can invade the epidermis (the outer layer of the skin) and cause infection and damage to the living tissue. The most visible damage is inflicted when dermatophytes settle down in the nail bed, where they are well protected by the nail plate, or matrix, the base from which nails grow out of and where they are protected by thick layers of skin. Toenails are infected more often that finger nails due to generally better hygiene.
Where can you get them?
Dermatophytes are transmitted by direct contact with an infected animal or human (skin, hair, fur) and indirectly when contact is made with and infected brush, seat, hat, furniture, bedding, towel, rug, floor or other surface in a public locker room or shower. Injuries to the skin, such as cuts, burns, and especially to the cuticle make a person more susceptible to fungal infections.
How to get rid of Dermatophytes?
Among the most common, and in all probability most widely known fungal foot infections is Athletes Foot. It is characterized by a redness of your skin and itchiness, which can often be quite excruciating. If you suffer from Athletes Foot you also have a 30% chance of getting another nasty fungal infection – a fungal nail infection.
Fingernails or toenails with broken or broken ends, in which the seals have been decayed, are vulnerable to a fungal infection. The majority of people, sadly, just perceive fungal nail infections to be unattractive and a trivial irritation. In fact, if not treated, fungal nails may result in more serious diseases.
Toenail Fungus flourish upon the damp and frequently confined conditions within the footwear and is a specific issue for many who suffer from sweaty feet and those who are athletically activity. The fungi themselves are called dermatophytes and are related to the more widely known candida yeast.
These seemingly trivial bacterial infections might also reveal much more serious underlying health-related problems such as circulatory issues and diabetic issues. They can also from time to time lead to a secondary infection. There are lots of ways that these bacterial infections may be transmitted. Most typical is the use of common shower towels that may transport the fungus, but different ways of passing the fungus are by means of shared shoes or socks, walking on contaminated areas and in many cases the use of unsterilized nail tools.
There may also be many factors that increase your threat of toe nail fungus infection for example nail damage, bad overall health, the frequent use of shared changing amenities, trauma to the nail by poorly fitted footwear and that perennial suspect – smoking.
Anyone who currently is affected with Athletes Foot must also get checked out for a fungal toenail infection as they are at an specifically high risk.
Nail’n’Toe is a very effective nail fungus treatment. The comprehensive approach of this advanced medical therapeutic protocol allows experienced practitioners deliver the best clinical results for their patients.
Many patients with ugly and obviously unhealthy nails consider this a cosmetic issue and put off the visit to a doctor till a better time. Is there a time when you absolutely must be seen by a doctor? The following two nail diseases should be considered as a late notice.
SCC in situ presents as flesh-colored or hyperpigmented verrucous papules or plaques with either keratosis or hyperkeratosis. The lifting of the nail plate (Onycholysis) can occur. Invasive SCC can begin as bone pain but is most commonly depicted as a slow-growing solitary subungual or periungual nodule that ulcerates and/or bleeds and likely destroys the nail.
Subungual SCC is the most common malignant tumor of the nail. Fingers are more likely to be involved (especially the first and fourth digits). Metastasis to the bone occurs 20%-55% of the time. Proximal and lateral nail plates, the nail matrix, and the hyponychium are affected (more about nail anatomy). Human papillomavirus (HPV) type 16, 18, 34, or 35 is detected in more than 60% of cases. HIV-positive patients are especially susceptible to developing HPV-associated squamous cell carcinoma. Cancer in this area is rare and usually a result of prior radiation therapy, but the prognosis is good when compared with that of SCC in other cutaneous sites.
Nail biopsy is necessary to make the diagnosis of subungual SCC. Mohs micrographic surgery is employed with noninvasive disease; the cure rate is around 96%. When bone is involved, amputation of the affected digit and/or radiation therapy can be used to destroy the unresectable tumor. If you are faced with a nail problem or lesion that won’t go away, consider a biopsy to rule out underlying subungual SCC.
- Peak incidence: 50-70 year old African Americans, Asians, and Native Americans.
- Looks like: brown-to-black pigmented nail band with blurred borders.
- Change in size of the nail band: recent, rapid, and sudden.
- Digit most commonly involved on hands or feet: first, followed by the hallux and second digit. Dominant hand more often involved, single digits more common than multiple digits.
- Extension of pigment into proximal or lateral nail plate (Hutchinson’s sign).
- Family or personal history of dyplastic nevus syndrome or previous melanoma.
Melanoma looks like a pigmented lesion that arises subungually or periungually and/or as a dystrophic nail plate, which developed after a traumatic incident.
Subungual melanomas represent 0.7%-3.5% of all melanomas. Five-year survival rates range from 16% to 87%, depending on extension/depth of the tumor. Amelanotic lesions account for 25% of cases.
Pyogenic granuloma shares some of the same characteristics as subungual melanoma. Both are dark-appearing growths. However, pyogenic granulomas are more papular; well-defined; fluctuant; sometimes tender; and a deeper, violaceous color similar to thrombosed blood.
Treatment: Biopsy is required to determine the extent of disease. When involvement is localized, surgical removal with clear margins is sufficient. More widespread involvement can be treated with amputation of the affected digit with or without systemic chemotherapy and use of interferon.
Outstanding survival capabilities of fungi has been demonstrated time and time again. An article in The Guardian reports on amazing findings by a group of scientists led by David Hughes at Harvard University. A fungus, Ophiocordyceps unilateralis, can infect ants, manipulate their behavior, turns them into zombies and makes them stagger to their death to spread on!
The oldest evidence of the fungus was found on the leaves of plants that grew in Messel, near Darmstadt in Germany, 48 million years ago.
The finding shows that parasitic fungi evolved the ability to control the creatures they infect in the distant past, even before the rise of the Himalayas.
The fungus, which is alive and well in forests today, latches on to carpenter ants as they cross the forest floor before returning to their nests high in the canopy.
The fungus grows inside the ants and releases chemicals that affect their behavior. Some ants leave the colony and wander off to find fresh leaves on their own, while others fall from their tree-top havens on to leaves nearer the ground.
The final stage of the parasitic death sentence is the most macabre. In their last hours, infected ants move towards the underside of the leaf they are on and lock their mandibles in a “death grip” around the central vein, immobilizing themselves and locking the fungus in position.
“This can happen en masse. You can find whole graveyards with 20 or 30 ants in a square meter. Each time, they are on leaves that are a particular height off the ground and they have bitten into the main vein before dying,” said David Hughes at Harvard University.
The fungus cannot grow high up in the canopy or on the forest floor, but infected ants often die on leaves midway between the two, where the humidity and temperature suit the fungus. Once an ant has died, the fungus sprouts from its head and produces a pod of spores, which are fired at night on to the forest floor, where they can infect other ants.
Tinea is the name of a group of skin and nail diseases caused by a fungus. Types of tinea include:
- Tinea pedis – foot infection (Athlete’s foot)
- Tinea cruris – infections affecting the groin, also called “Jock itch”
- Tinea capitis – scalp
- Tinea corporis – body areas, aka ringworm
- Tinea barbae – beards
- Tinea unguium – nails
Most of these infections are usually not serious, but they can be uncomfortable. You can get them by touching an infected person, from damp surfaces such as shower floors, or even from a pet.
Fungal and yeast infections, also called Mycoses, are caused by a fungus, a primitive vegetable, which grows in all warm, moist areas and spots, which lack light exposure. Mushrooms, mold and mildew are examples of fungi, which live in air, soil, water and on plants. Some live in the human body. Only about half of all types of fungi are harmful to humans.
Some infections are caused by yeast (scientific names: Candida, Candidiasis, Moniliasis), which is a type fungus that lives almost everywhere, including in your body.
Usually, your immune system keeps yeast under control. If you are sick or taking antibiotics, it can multiply rapidly and cause an infection.
Some fungi reproduce through tiny spores in the air. You can inhale the spores or they can land on you. As a result, fungal infections often start in the lungs or on the skin. You are more likely to get a fungal infection if you have a weakened immune system or take antibiotics.
Fungi can be difficult to kill. For skin and nail infections, you can apply medicine directly to the infected area. Oral anti-fungal medicines are also available for serious infections.
Some of the better over-the-counter creams and powders may help get rid of many tinea infections, particularly athlete’s foot and jock itch. Other cases require prescription medicine.
Fungal infections under nails, aka Tinea unguium or Onychomycosis, are typically very hard to treat, because the nasty fungi are protected by nails. Topical medications cannot penetrate through the nail. Oral medications may be toxic and are not recommended for elderly people and diabetic patients.
Comprehensive and sophisticated therapeutic methods are required to eliminate fungus in toes and fingers and prevent reinfection.