Candidiasis of okolonogevyh rollers and nails

Candida onychia and paronychia are the most frequent forms of superficial candidiasis caused by fungi of the genus Candida. This is a conditionally pathogenic, spontaneous dimorphic fungi, which are facultative anaerobes.

They are found in air, soil, vegetables, fruits, confectionery. These fungi are representatives of normal intestinal microflora, oral mucosa, external genitalia and areas adjacent to natural openings that are associated with natural reservoirs of Candida fungi. In the development of the disease, an important role is played by factors contributing to the weakening of the immune defense of the macroorganism. The endogenous factors leading to the development of this mycosis include endocrine disorders (hypercorticism, diabetes, obesity, hypothyroidism and hypoparathyroidism), severe general diseases (lymphoma, leukemia, etc.), congenital and acquired immunosuppressive conditions, including HIV- infection. Currently, the most often the development of candidiasis is the reception of antibacterial drugs with a wide range of action; systemic glucocorticosteroids, cytostatics, oral contraceptives. A number of exogenous factors can also lead to the development of candidiasis. These include increased temperature and excess moisture, leading to maceration of the skin, microtrauma, skin damage by chemicals, etc. The development of candidiasis onions and paronychia can be facilitated by frequent contact of the skin of the hands with water, soil, and also with solutions containing glucose, fructose and others. Sugar, for example, in the confectionery industry.

Symptoms of candidiasis of okolonogennyh ridges and nails

In contrast to onychomycosis caused by filamentous fungi, with candidiasis onyxis primary lesion of the nail roller takes place. Inflammatory candidiasis paronychia is characterized by erythema and edema in the area of the nail roller. In the future, the epochchium disappears and the edematous nail roller overhangs the nail. When pressing on the nail roller from under it can appear a purulent discharge. Gradually, the nail plate is involved in the process, the change of which always begins with the proximal part. The nail thickens, becomes dull, dirty-gray or even dark-brown in color, transverse furrows appear, sometimes point impressions.

Diagnosis of candidiasis of okolonogennyh ridges and nails

Clinical diagnosis of candidiasis paronychia and onychia must be confirmed by microscopic and cultural studies. An important role in the diagnosis of candidiasis is played by the growth of the titer of the colony during multiple plantings for several days or the progression of the disease.

Differential diagnosis of candidiasis of okolonogennyh ridges and nails

The candidiasis paronychia should be differentiated from the streptococcal paronychia. The defeat of nail plates in candidiasis can resemble onychomycosis caused by filamentous fungi, as well as psoriasis of nails and peri-nasal grooves.

Treatment of candidiasis of okolonogennyh ridges and nails

In case of isolated candidal onychia, external agents with antifungal activity are recommended: polyene antibiotics - natamycin (Pimafucin), azoles - clotrimazole (clotrimazole, Konesten, Candide, etc.), ketoconazole (Nizoral), miconazole (Dactarin), bifonazole (Mikospor), econazole (Levaril), isoconazole (Travogen), etc. In the defeat of nail plates, systemic antifungal therapy with preparations from the azole group (fluconazole-Diflucan, itraconazole-Orungal) is shown. A detailed analysis of the causes of the development of the disease and the elimination of predisposing factors are also required.

Patient management with onychodystrophy

Correct and comprehensive management of patients with onychodystrophy is extremely important, since this condition is a background condition for the subsequent development of onychomycosis. Patients are recommended adequate care for nail plates. Most preferable manicure and pedicure without the use of metal tools and without cutting the eponymic with scissors (the so-called "European" manicure). To this end, use wooden sticks and saws. For the rapid removal of the keratinized areas of the eponymy, special gels or creams with keratolytic agents (salicylic acid, lactic acid, etc.), which are prescribed not only before the procedures, but also between them, are used. Recommended hardware methods of manicure and pedicure. Also shown are special moisturizing creams for nail plates and various protective and firming coatings.

Compulsory is a gentle regime: avoid contact with aggressive liquids, surfactants in the home and at work, use protective gloves.

In therapy use means and methods that improve the microcirculation of the extremities (preparations of nicotinic acid, belladonna, agapurine, various physiotherapeutic procedures), vitamins, iron and zinc preparations. In recent years, combined preparations have become very popular (Innes - hair density, "Innaov Laboratories", Bjuti-tabs charm, "Ferrosan", Merz Special Dragee, "Merz", etc.). If oniostrophy is a manifestation of any dermatosis, active therapy of the underlying disease is indicated.

In cases of persistent onychomadesis or with an aesthetic purpose, with pronounced deformation of the nail plates, modern nails with the use of polymer coatings can be used). When choosing a technique, it is necessary to remember the possible intolerance of a number of components that make up special glues or artificial coatings (formaldehyde resins, acrylates, etc.).

It should be emphasized that only complex and long-term therapy of onychostrophy can be effective in this pathology.