Tinea Unguium
Posted by recep on June 25th, 2009Tinea Unguium
A fungal infection of the nails (more often the toenails than the fingernails), usually caused by Trichophyton rubrum or T. menta-grophytes. The nails may become grossly thickened and so enlarged that wearing shoes becomes painful.
Treatment: Treatment is prolonged and rarely warranted. Fingernails may be treated with griseofulvin 500 to 1000 mg/day for 6 to 9 mo; toenails require 12 to 18 mo of such therapy. The overall cure rate is 40% to 70%. Although fingernails are more likely to respond to treatment than toenails, recurrence within 1 yr is common; recurrence in toenails is nearly 100%. Available topical antifungals are fungistatic and do not penetrate the nail plate in sufficient concentration to eradicate infection. Fungicidal agents now under investigation offer the prospect of effective topical therapy for tinea unguium. In elderly patients whose main problem is discomfort, conservative management including periodic trimming by a podiatrist may be the most practical approach.
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