Onychomycosis Pathophysiology

Onychomycosis (OM) refers to a fungal infection that affects the toenails or the fingernails. Onychomycosis may involve any component of the nail unit, including the nail matrix, nail bed, or nail plate. The recent proliferation of fungal infections in the United States can be traced to the large immigration of dermatophytes, especially Trichophyton rubrum, from West Africa and Southeast Asia to North America and Europe.

The incidence of onychomycosis has been reported to be 2-13% in North America. A multicenter survey in Canada showed the prevalence of onychomycosis at 6.5%. Onychomycosis accounts for half of all nail disorders, and onychomycosis is the most common nail disease in adults. Toenails are much more likely to be infected than fingernails.

Thirty percent of patients with a cutaneous fungal infection also have onychomycosis. The incidence of onychomycosis has been increasing, owing to such factors as diabetes, immunosuppression, and increasing age. Studies in the United Kingdom, Spain, and Finland found prevalence rates of onychomycosis to be 3-8%.

The main subtypes of onychomycosis are distal lateral subungual onychomycosis (DLSO), white superficial onychomycosis (WSO), proximal subungual onychomycosis (PSO), endonyx onychomycosis (EO), and candidal onychomycosis. Patients may have a combination of these subtypes. Total dystrophic onychomycosis refers to the most advanced form of any subtype.

The pathogenesis of onychomycosis depends on the clinical subtype. In DLSO, the most common form of onychomycosis, the fungus spreads from plantar skin and invades the nail bed via the hyponychium. Inflammation occurring in these areas of the nail apparatus causes the typical physical signs of distal lateral subungual onychomycosis. In contrast, WSO is a rarer presentation caused by direct invasion of the surface of the nail plate.

In PSO, the least common subtype, fungi penetrate the nail matrix via the proximal nail fold and colonize the deep portion of proximal nail plate. EO is a variant of distal lateral subungual onychomycosis in which the fungi infect the nail via the skin and directly invade the nail plate. Total dystrophic onychomycosis involves the entire nail unit.

Nail invasion by Candida is not common because the yeast needs an altered immune response as a predisposing factor to be able to penetrate the nails. Despite the frequent isolation of Candida from the proximal nail fold or the subungual space of patients with chronic paronychia or onycholysis, in these patients Candida is only a secondary colonizer. In chronic mucocutaneous candidiasis, the yeast infects the nail plate and eventually the proximal and lateral nail folds.

Onychomycosis is not life threatening, but it can cause pain, discomfort, and disfigurement and may produce serious physical and occupational limitations. Psychosocial and emotional effects resulting from onychomycosis are widespread and may have a significant impact on quality of life. Once contracted, it is extremely difficult to remove completely.

The incidence of onychomycosis is increasing with no real satisfactory cure. Fungus occurring under nails is usually beyond the reach of standard remedies which are simply not strong enough and permeable to actually get rid of the infection. However, application of AntiNailFungus-Rx 2-3 times per day has shown to eliminate even the toughest nail fungus infections.

It is concentrated with naturally occurring phenolic compounds which exhibit a tremendous antifungal activity. They safely destroy fungal infections and act as natural pharmaceuticals. As most standard treatments for fungal infections are not effective against fungus which has worked its way under the nails, the antifungal effects of this product are of increasing interest.

Clinical evidence supports laboratory tests which show that theses extracts have penetrating antifungal actions which destroy fungi without causing tissue damage. However, this treatment is very potent and therefore only to be applied to finger/toe nails where skin and nails are hardened and less sensitive. To learn more, please go to http://www.naturespharma.org.