What are the clinical manifestations of onychomycosis

The problem of onychomycosis causes great pain to many people. Sometimes, they dare not even stretch out their hands in public. They are particularly inferior and often show symptoms such as discoloration, softening, and roughening of the nail plate. In many cases, this is caused by fungal infection.

1. Distal subungual onychomycosis (DSO)? This is the most common type. The fungus begins to invade the subungual stratum corneum of the distal lateral edge, and then invades the bottom surface of the nail plate, gradually causing the nail plate to change color and deteriorate, losing its normal smooth appearance. Debris of the nail bed stratum corneum accumulates under the nail plate, causing the nail plate to separate and fall off, or be cut off by the patient, resulting in the loss of the entire nail plate, leaving behind a hyperkeratotic nail bed. Some fungi can produce different pigments, such as Brown produced by Cladosporium brevis and Black produced by Coccidioides sphaeroides. The pathogens on the toes are Trichophyton rubrum, Trichophyton mentagrophytes, Epidermophyton floccosum, Scopulariopsis brevis, Aspergillus, Fusarium, Cephalosporium, Candida albicans, Candida tropicalis, Candida parapsilosis, Geotrichum candidum and Ascochyta sphaeroides; the pathogens on the fingers are Trichophyton rubrum and Candida albicans.

2. White superficial onychomycosis (WSO)? Less common. The fungus invades directly through the superficial layers of the nail plate, forming small, superficial white spots that enlarge and fuse. Eventually the nail becomes soft, rough, and amber in color. The pathogens of the toe are Trichophyton mentagrophytes, Cephalosporium, Aspergillus and Fusarium. Trichophyton rubrum is rare.

3. Proximal subungual onychomycosis (PSO)? Typically seen at the proximal end of the fingernail, it begins as a white spot and can expand into a white spot. The underside of the nail plate is affected, but the entire nail can be involved. The primary type is rare. Trauma, diabetes, psoriasis, chronic paronychia and peripheral vascular disease may lead to this type of infection. This type of disease has increased with the rise in AIDS incidence abroad. The pathogens on the toes were Trichophyton rubrum, Trichophyton mentagrophytes, Trichophyton schurensis, Trichophyton tonsurans, and Trichophyton magni, while those on the fingers were Trichophyton rubrum and Trichophyton magni.

4. Total dystrophic onychomycosis (TDO) is the final stage of development of the above three types, in which the entire thickness of the nail is affected.