Bacterial toenail infections quizlet,home remedies for sinus congestion apple cider vinegar uses,list antibiotics for bacterial infections contagious - Reviews

18.10.2014, admin
Specialised TreatmentsOur experienced podiatrists treat a whole range of conditions and symptoms. Toenails infected with a fungus are relatively common affecting between 3-10% of the UK population. Normally the infection is predisposed by trauma to the nail, particularly repeated trauma and hence is more prevalent in hill walkers, footballers etc. Anyone with a history of chronic skin fungal infection of the foot (athletes foot) is also at much greater risk of toenail fungal infection. The definitive means of diagnosis is to take nail clippings and send them for culture and microscopy, however there is often a high incidence of false negative results and thus only a positive result can be relied upon. Differential diagnosis would include :-  Psoriatic nails, thick damaged toe nails, bruising under the nail, bacterial infection under the nail, lichen planus, nails affected by eczema, or a combination of any of these conditions. Many patients with relatively minor fungal nail infections are happy to ignore the problem and this is an approach we would encourage. Research suggests the most efficacious topical preparations are products containing Amorolfine at 5% concentration (Curanail or Loseryl).
In order to aid the effectiveness of topical treatments it is ESSENTIAL that the infected area of the nail and any loose ‘debris’ underneath is debrided (paired down) meticulously and regularly by a Podiatrist every 6-8 weeks for as long as the preparation is being applied. In addition to topical treatments demonstrating poor rates of cure, they have to be applied regularly for at least 18 months. The exception to this rule would be where a patient has a form of fungal nail infection known as ‘white superficial’ onycomycosis (see above photo). Research would suggest that tablets containing Terbinafine are perhaps the most effective and a patient with toe nail fungal infection would be expected to take one 200mg Terbinafine tablet daily for three months (one month for finger nails). Oral Terbinafine will provide on average about a 60% chance of successfully treating fungally-infected toe nails. A treatment regime of 200mg Terbinafine tablets taken for at least three months, in combination with the weekly application of an Amorolfine based paint will achieve a higher rate of cure than just taking tablets alone. The application of the paint begins when the tablets are first taken and must continue to be applied once weekly for at least 18 months after the tablets have been discontinued. Research has shown that if patients adhere diligently to this combined treatment regime of oral Terbinifine tablets and topical Amorolfine paint a cure rate of 70% can be achieved. The use of Lasers for fungal toenail treatment involves raising the temperature of the nail bed to levels that kill the fungal hyphae without exposing the patient to any significant discomfort.


There has been much anecdotal evidence that suggested this form of treatment could produce marked improvements to the aesthesis of the nail.
We have now invested in this technology and are pleased to be able to offer this treatment. Many people who have tried a variety of treatment regimes (even under the supervision of a proficient Podiatrist) may have to accept that their toe nail fungus cannot be cured. Some patients choose (particularly before special occasions like holidays) to come to us for Wilde-Pedique Nail Reconstruction  which is a wonderful way of making an unsightly fungally infected toenail look normal and will last for several weeks (visit our website for more details). Fungal Nail Infection is often difficult to cure and patients are strongly advised to consult a practitioner who has an intimate familiarity of all the possible treatments.
If you suspect that you have a fungally infected toe nail and are not sure what to do then why not consult one of our Podiatrists.
Nail fungus is a common condition that begins as a white or yellow spot under the tip of your fingernail or toenail. People who often go to public swimming pools, gyms, or shower rooms, and people who sweat a lot often have these infections. The most common sign of a fungal nail infection is the nail becoming thickened and discoloured. A fungal nail infection is usually painless at first, and in most cases it won’t cause any further complications.
If you have pain in the affected toenail, it can eventually make walking and wearing shoes difficult. As the infection progresses you may experience other symptoms, such as the nail becoming brittle, with pieces of nail breaking off and coming away from the toe or finger completely. Fingernail infections are also more likely to occur if you wash your hands frequently, or have them in water a lot. You have an increased risk of developing a fungal nail infection if you have various other conditions. Your health care provider will do lab tests to check for liver damage while you are taking these medicines. The condition is also more common in people with poor peripheral circulation and who are immuno-compromised. An experienced practitioner can confidently offer a diagnosis based on visual inspection in the majority of cases.


However when the cosmetic appearance becomes unacceptable to the patient, or if the nail becomes thickened to such an extent that it rubs inside the toe box of a shoe, then treatment can be considered. In most cases a modest improvement in the aesthesis of the nail is the most realistic outcome of treating fungally infected toe nails with topical treatments. White superficial fungal nail infection only affects the upper layers of the nail plate and can be treated topically even where there are several nails affected.
Additionally, any affected nail must be kept short, and if thickened, must also be thinned regularly by a Podiatrist, thus maximising the effect of the paint. However, until recently there had been no quality research published that supported these claims.
Where this occurs there is a lot we can do to ‘disguise’ the affected nail(s) and dramatically improve the appearance of such nails. This would involve our Podiatrists drilling down any excess thickness of the nail, clearing any debris from under the nail. You will therefore increase your chances of a better outcome dramatically by consulting ourselves BEFORE any treatment regime (if any) is chosen and commenced. This is one of the most common foot pathologies seen by Podiatrists and we can ensure that you will receive treatment from a practitioner who is very familiar with your problem. These curing techniques should only be applied when the infections become very serious and there are many risks to lose the fingers. As the fungal infection goes deeper, nail fungus may cause your nail to discolor, thicken and crumble at the edge. But if the infection isn’t treated, it may cause pain and discomfort, although this is rare.
White or yellow patches may also be visible on the nailbed, or you may have scaly skin next to the nail. For example: diabetes, psoriasis, poor circulation, a poor immune system (for example, if you have AIDS or are on chemotherapy), or a general poor state of health. However a study in 2014 undertaken by the University of Barcelona involving 150 patients achieved a cure rate of 78%.



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