Early symptoms of onychomycosis in children

In life, have you noticed that some people's fingernails or toenails are different from those of ordinary people? The most obvious thing is that their nails are thicker than those of ordinary people, and the color of their nails is also different. Some are yellower, and some are darker. If you see someone's nails have this condition, then it is obvious that this person has onychomycosis, which is a disease caused by fungi. This disease is highly contagious. If this happens, we must seek treatment in time. The early symptoms of onychomycosis are not so obvious, and many people cannot detect it, which causes the symptoms to worsen. Let us take a look at the early symptoms of onychomycosis in children.

Common symptoms of onychomycosis:

Typical symptoms: thickened nails, yellow nails, red or black spots on nails, nails that resemble mica, brittle nails, brown pigmentation on nails and ear cartilage, changes in nail color, abnormal nails, yellow spots on nails

1. Symptoms:

Subungual onychomycosis: It often starts on the sides or ends of the nail plate. At first, there is mild paronychia, which gradually becomes chronic or gradually disappears. Paronychia can cause pits or grooves on the nail surface, starting as small, distinct yellow or whitish spots that persist or gradually involve the nail root. Once the nail plate becomes infected, it may develop cracks, become brittle or thickened, and turn brown or black. Keratin and debris may be deposited under the nail. Under normal circumstances, the nail bed does not participate in the keratin formation of the nail plate, and only forms keratin under the nail plate. When the nail bed is invaded by fungi, it can stimulate the formation of soft and brittle keratin, so that the nail becomes loose, and the deposition of keratin causes the nail plate to become significantly thickened. In candidal onychomycosis, there is no debris deposition and the nail plate does not thicken. Because nail bed debris and nutrients such as keratin provide rich nutrients for fungal growth, the fungus grows rapidly, allowing the fungus to directly invade the hard nail plate from below and stimulate the nail bed to form more keratin, making the nail plate thicker. At the same time, other fungi or bacteria may also invade the debris area. The nail matrix is ​​usually not affected, but some may experience slight changes in shape and color. When infected by Trichophyton rubrum, the distal end of the nail plate will crack and separate, leaving a thin groove with rough edges. When it spreads to the entire nail, it may destroy the entire nail.

Fungal leukonychia is also known as superficial white onychomycosis. It initially presents as a small turbid area on the surface of the nail plate. It is often dot-shaped at first, with an irregular shape and an indefinite number of dots. It starts from the central near-crescent area of ​​the nail surface, the free edge of the nail, or the two folds. It can be limited to one place or affect the whole armor. The nail surface is soft and sometimes there are no symptoms. The infection can persist for many years. The onychomycosis caused by Trichophyton gypseum is relatively superficial, without paronychia. Desquamation can be seen in the skin of the nail bed folds. Most of the time, only part of the nail is affected, but sometimes the entire nail plate can be invaded.

Onychomycosis caused by Candida albicans is often accompanied by paronychia, which initially occurs in the folds on both sides and may have a small amount of pus. The overlying skin becomes red, swollen, and tender. The skin near the nail becomes dark, rises, and separates from the nail bed beneath it, and eventually the entire nail plate is affected. Fingernails are more susceptible to infection than toenails. It is more common in housewives, cooks and people who often come into contact with water. The nail plate does not become soft like that caused by trichophyton infection. Onychomycosis can sometimes be caused by yellow mold, and there may be a lot of debris under the nail plate.

The fungus can be easily found by PAS staining of the diseased nails of subungual onychomycosis. Mycelium and arthrospores can be seen in the nail plate layer, which is generally confined to the lowest part of the nail plate. Onycholysis is not a characteristic of dermatophyte infection, but rather the nail plate is mechanically divided by the fungus growing therein, the distribution and number of fungi within the nail plate varying. The nail plate tissue may show little or no inflammation.

In fungal leukonychia, the fungal hyphae are often confined to the uppermost part of the nail plate and rarely spread to deeper layers. A large number of hyphae can be seen on the upper part of the nail plate, which are larger and wider than those seen in subungual onychomycosis. The sections often contain swollen hyphae and irregular joint spores.

In onychomycosis caused by Toxoplasma brevis, its molecular spores can often be found inside the nails. Candidal onychomycosis is often accompanied by chronic paronychia, which causes destruction of the nail structure and is accompanied by a chronic inflammatory response. Fungi can be found in the nails and their loose tissues in onychomycosis caused by yeast. Nail diseases caused by other fungi will have debris in the nail groove and nail bed, and hyphae can be seen in the sections.

2. Classification of onychomycosis:

1. Proximal subungual onychomycosis: It is less common and most of the cases are secondary to paronychia. First, the nail plate turns white near the nail wrinkle (i.e. the proximal end of the nail plate), then gradually expands into spots, and finally part of the nail plate is lost and expands to the entire nail. This type is only caused by Trichophyton rubrum and Trichophyton rosea.

2. Distal subungual onychomycosis: The initial manifestation is irregular small white spots appearing on the nail plate surface at the distal end (lateral edge), which then turn into dull gray spots and gradually turn into yellow-brown and finally black. Soon the nail plate deteriorates, keratinous debris accumulates under the nail, and the nail bed thickens. Finally, the nail plate becomes atrophic and occasionally bleeds. This type is often caused by red, gypsum or floccosus Epidermophyton.

3. White superficial onychomycosis: commonly seen on fingernails and toenails. It manifests as white spots or white patches with a diameter of 1 mm on the surface of the nail plate. The diseased nails are brittle and will fall off if scraped off. This type is only caused by Trichophyton gypseum or Trichophyton, Fusarium and Aspergillus.

4. Onychomycosis caused by pan-onychia dystrophy: This is not common and is often the final development of the above types. The symptoms include the entire nail losing its luster, deteriorating, thickening or breaking, and leaving behind an abnormally thickened nail bed after falling off.

5. Chronic mucocutaneous candidal onychomycosis (or true candidal onychomycosis): the nail becomes completely deteriorated, swollen, and brittle, with a wart-like and uneven surface.

6. Chronic paronychia type onychomycosis: manifested by degeneration or browning of the lateral nail folds, proximal nail folds, and epidermal cuticle. The most important feature is the presence of paronychia, swelling of the periungual folds without subungual hyperkeratosis, and a small amount of exudate but never pus. This type is also mostly caused by Candida albicans.

7. Fungal onychomycosis: Symptoms include severe athlete's foot (commonly known as "Hong Kong foot"), rot in the toe grooves, and water rash.

Common complications of onychomycosis:

Paronychia

1. Concomitant Diseases

There are many complications: The nails of patients with onychomycosis are exposed to the outside. Once they are injured by various kinds of trauma, bacteria can easily spread and cause complications such as paronychia, onychomycosis, and pyoderma of the fingers.