Ungual Dermatophytosis

Ungual dermatophytosis, also known as Tinea  unguium or dermatophyte onychomycosis is simply tinea of the nails.  The condition usually starts at the tip of the nail and over time the nail will gradually thicken, discolor and crumble.  Without treatment the nail may be completely destroyed.

There are two main types of ungual dermatophytosis.  The first is superficial white onychomycosis.  In this form the fungal invasion is restricted to patches or pits on the surface of the nail.

Invasive subungual dermatophytosis is the second for of ungual dermatophytosis and as the name suggests is more invasive and severe.  In this form the lateral, distal or proximal edges of the nail are first involved followed by the development of an infection beneath the nail plate.

The most common form of dermatophyte onychomycosis affects the distal portion of the nail.  The fungal invasion leads to hyperkeratosis of the nail bed and the eventual thickening of the nail bed.

Ungual Dermatophytosis a common condition

Ungual dermatophytosis affects approximately 3% of people living in countries like the USA, UK and Australia and is slightly more common in the elderly with about 5% of the older population affected.

The condition is more common amongst groups where communal showers and changing rooms are used, such as with miners, servicemen and sportsmen.  In these groups the incidence rises to around 20%.

Check the cause before treating

The presence of dystrophic nails does not necessarily indicate a fungal infection and it is important to determine the cause of the problem before treatment is commenced.  Accurate diagnosis requires microscopy and/or culture of the affected area.  As the dermatophyte lodges deep in the nail, antifungal creams are rarely sufficient to effectively treat ungual dermatophytosis and an oral treatment is required.