The topic here is onychomycosis.
What does that mean?
It’s a fungal infection
of nail plate or nail bed.
If it’s one thing that you want take out of
this fungal infection,
onycho- means nail.
Caused by dermatophytes
or some saprophytes.
of the nail bed.
Demographics: 20% will be of
the elderly, onychomycosis.
Caused by thickened, dystrophic and
discolored toenail, with crumbling,
and it’s called onycholysis.
So the onychomycosis at some point
when it then affects your nail bed,
you cause destruction of it,
we call this onycholysis.
Note the only cause of dystrophic
nail is onychomycosis,
or maybe a saprophyte.
If you then take look at the
nail here on your left,
you’d find this to be a very
dystrophic nail in onychomycosis.
Diagnosis: Must prove the
diagnosis before treatment,
and may perform as you can imagine,
a KOH prep or nail biopsy.
You need to make sure that
you at first confirm it.
And once you do, know that often treatment
is restricted to the finger nail.
and those with ambulatory issues,
and by that we mean what?
Difficulty with movement.
Requires oral antifungals
for prolonged course.
Once again, we have terbinafine
or an azole drug as itraconazole.
A scabies infestation of the mite –
The name of the mite here is
called your Sarcoptes scabiei.
Healthy persons may only have a
dozen mites on the entire body
whereas an immunocompromised individual get
crusted scabies with millions of mites.
Doesn’t that sound like a
wonderful, wonderful discovery?
So what does this look like
on your skin with scabies?
they burrow into the superficial
skin and there they go and plop!
They drop feces and eggs.
Allergic reaction occurs in the material
that’s been produced by the mite.
Pruritic rash with the presence
of small linear type of burrows.
And then the burrow
often found where?
The wrist or between the fingers,
in the webs of the fingers.
In an adult, the face, neck and
scalp are typically spared,
is something that you
want to keep in mind.
Here’s a patient that has scabies
and I want you to focus upon –
This is a baby and you’ll notice that
it’s on the legs, it’s on the chest,
and you’ll also find it in between the
fingers and the webs of the fingers.
Scabies, remember the female mite?
It got in there and dropped
its eggs or maybe feces
and then there’s an allergic reaction
in which this poor child was
Scabies prep using a scalped blade
and the burrows are scraped.
Examination of your material
underneath the microscope
and the mites, the eggs, and the feces
are then diagnostic, obviously.
maybe a few dozen,
maybe a dozen.
If it’s in immunocompromised, we’re
talking about millions with those crusts.
Family members for sure
and launder the
Burn them if you need to.