Patient Education Of Onychomycosis
Onychomycosis is the medical term for a fungal infection of the nail. It can affect toenails or fingernails, though, as the fungus thrives in dark, damp environments, toenail infections are more common. Onychomycosis in patients who are immunocompromised is associated with increased severity and morbidity.
Lesions may appear atypical and require more aggressive management compared with the healthy population. Proximal subungual involvement is much more prevalent in patients with HIV infection than in those without HIV infection. In this population, white superficial onychomycosis is more commonly caused by T rubrum, rather than T mentagrophytes.
The diabetic foot may lead to serious complications associated with onychomycosis. Peripheral neuropathy and sensory loss may lead to increased trauma without pain in patients with diabetes. Bacterial colonization and vascular insufficiency may exacerbate the problem and may lead to serious sequelae.
Onychomycosis in elderly people is complicated by diseases (eg, poor vision, arthritis) that prevent optimal foot care.
Nail changes are much more common in elderly persons and often involve the fingernails and the toenails. The potential for drug-drug interactions is more evident and must be addressed before initiating oral therapy.
The goals for antifungal therapy are mycological cure and a normal looking nail. Mycological cure can be evaluated at the end of treatment, while clinical cure requires several more months owing to slow nail growth. Clinical trials have repeatedly demonstrated higher efficacy for terbinafine compared with other antifungal treatments.
A meta-analysis of 18 studies on terbinafine, 6 studies on pulse itraconazole, and 3 studies on fluconazole for onychomycosis showed a mycological cure rate of 76%, 63 %, and 48 % respectively. Onychomycosis caused by molds, particularly Fusarium species, are often not responsive to systemic therapy.
Yellow streaks along the lateral margin of the nail and/or presence of yellow onycholytic areas in the central portion of the nail (dermatophytoma) are associated with a poor response to treatment. Residual nail changes persist in most patients as a result of the frequent association of onychomycosis with traumatic toenail dystrophies.
Recurrence (relapse or reinfection) of onychomycosis is not uncommon, with reported rates ranging from 10-53%. Fungal infections of the fingernails have a much more favorable prognosis than toenail infections. Patients should be educated about the use of appropriate footwear, especially in high-exposure areas such as communal bathing facilities and health clubs.
Following treatment, patients must be advised that nails may not appear normal for up to 1 year, and prophylactic antifungal therapy may be required to prevent reinfection of the skin and the nails. Patients may use topical terbinafine cream twice daily for 1-2 weeks for early tinea pedis or a 1-week pulse of itraconazole at the first signs of onychomycosis.
The problem with using chemical drugs to treat nail fungus is that unlike bacteria, both human and fungal cells are similar on a molecular level; they are both eukaryotes. As a result, it is very difficult to create an effective antifungal drug that does not also damage the human system. There is a powerful nail fungus treatment from CURED – NailFungusCure.
This topical anti fungal agent delivers a broad spectrum of action against fungi causing nail fungus, meaning it kills the fungus and acts as a curative agent. The treatment has a proven ability to eliminate and cure nail fungus on the toes and fingers time after time. It is possibly the most powerful and effective topical nail fungus treatment on the market.
NailFungusCure contains very potent certified organic medicinal plant extracts and antifungal essential oils. These extracts exhibit a wide spectrum of antifungal activity, and in laboratory tests they have demonstrated their ability to kill the fungi causing nail fungus infections. Results are usually experienced in a matter of days.
The antifungal properties of NailFungusCure are able to stop germination of the fungus. This restricts the infection from spreading to adjacent body parts or nails, which is necessary to properly treat nail fungus. To learn more, please go to http://www.bcured.net.