Localized in the region of the fingernails and toenails, Tinea Unguium (commonly referred to as ringworm of the nails) is by far the most problematic form of ringworm, requiring specialized medical care and repeated treatments with strong antifungal agents. Unlike other forms of ringworm, which are generally easier to treat using a single course of specific local medications, Tinea Unguium is very persistent and can lead to serious complications if it is inappropriately treated. Despite the fact that ringworm of the nails is more likely to occur among the elderly, the disease is also commonly seen among young people and even children.
Ringworm of the nails is caused by infection with fungal organisms, which infest the body of human hosts and localize at the level of the toenails or fingernails. People who acquire other forms of ringworm, such as ringworm of the feet or ringworm of the body (the most common type of Tinea, infesting the superficial layers of the skin) are very exposed to developing Tinea Unguium as well.
Similar to all other types of ringworm, Tinea Unguium can be acquired through direct physical contact (by touching individuals affected by the disease) or indirect physical contact (prolonged exposure to contaminated objects). Tinea Unguium, especially when localized at the level of the feet, is often acquired indirectly, by washing with contaminated water or by wearing clothing articles infested with Tinea fungal organisms (shoes, socks, gloves). The first signs of ringworm of the nails are: thickening, discoloration and increased sensitivity in the region of the toenails or fingernails. As the disease progresses, the infected toenails or fingernails begin to exfoliate and break off, either at the extremities or on the sides. In the absence of treatment, Tinea Unguium can cause serious damage at the level of the nails, rendering the affected people very vulnerable to serious bacterial infections as well.
Ringworm of the toenails and fingernails is generally diagnosed upon local examinations under the microscope. In order to diagnose less revealing forms of Tinea Unguium (ringworm of the nails generates no conclusive symptoms in the incipient stages of infection), doctors may decide to take samples of the diseased corneous tissue for further analyses in the laboratory. Once the presence of Tinea Unguium is confirmed in a patient, the doctor will prescribe an appropriate medical treatment. The active medications are often associated with analgesics and anti-inflammatory drugs. An additional treatment with antibiotics is usually prescribed to patients who show signs of secondary infestation.
The most commonly prescribed Tinea Unguium medication consists of Griseofulvin, a strong and effective antifungal drug for localized use. However, Griseofulvin is less effective in overcoming infections with this type of Tinea. For advanced forms of ringworm of the toenails and fingernails, doctors may prescribe various other treatments such as microbiological cures or combined antifungal medications. In some cases, patients who don’t respond well to local treatments may even require surgical treatments, the removal of the diseased nails being their only option available. However, nowadays surgery is rarely performed on patients affected by Tinea Unguium, doctors preferring to treat the disease with topical medications.
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