Proximal subungual onychomycosis is typically found in those with compromised immune system challenges. It is least commonly found in individuals with healthy immunity. This form of onychomycosis stands out since it begins at the cuticle area and grows with the nail.
The Nail Infection
This type of nail infection usually causes the nail to become disfigured, which is also common among other types of onychomycosis. The difference is that it will begin at the cuticle area and move with the nail as it grows. This will cause the nail to have dips, bumps, and irregularities. The infection involved with proximal subungual onychomycosis will infect the nail bed much earlier and can cause the nail to come off. It can dislodge from the bed and completely lift off which will expose the nail bed to more potential infections.
Causes of Infection
The causes of infection for this type are similar in nature to Distal Subungual Onychomycosis. Usually the biggest number of cases is caused by dermatophyte (Trichophyton ruburm). Keep in mind that proximal subungual onychomychosis can also be triggered by another dermatophyte called Trichophyton mentagrophyte.
Proximal infections can be caused by mold. Symptoms of proximal subungual onychomycosis can include: appearance of mold, red swollen skin which is around the nail, inflammation, and oozing pus. This is commonly seen with this nail infection.
The symptoms discussed are very similar to those of a bacterial infection, creating possible misdiagnosis. Antibiotic therapy will not necessarily stop the infection, nor rid the body of symptoms. In this situation, an antifungal medication is needed for proximal subungual onychomycosis treatment. This will help to get rid of molds, dermatophytes, and yeasts.
Seen More Often
This type of nail infection is seen more often in those who have immune deficiencies. Their immune systems are depressed, or down, as compared to having a healthy immunity. Proximal subungual onychomycosis is rarely seen in individuals with healthy immune systems.
Immuno-depression (scientific name) can be a result of an individual having chemotherapy, or in people with an autoimmune disease. Sometimes, individuals who have undergone an organ transplant will become infected. This is partly due to the fact – their immune systems are deliberately suppressed.
Proximal subungual onychomycosis is also seen in individuals with HIV, or immunodeficiency virus. If a physician can find no other causes of this form of nail infection, they will commonly order a HIV test to rule out the disease. Please be prepared for this if you have been diagnosed with this form of nail infection.
Physicians must have your consent to run a test for HIV. If you have been diagnosed with proximal subungual onychomycosis, this does not necessarily mean that you will test positive for the HIV virus.
Proximal Subungual Onychomycosis Treatment
Treatment for this type of nail infection is often taking an oral anti-fungal medication. Here is more information which may prove helpful:
• Infection caused by Trichophyton rubrum or Trichophyton mentagrophytes – your physician will likely prescribe terbinafine, which is also known as Lamisil
• Infection cause is unknown – your physician will likely prescribe itroconazole, which is also known as Sporanox
The dosage of Lamisil is usually one pill each day containing 250 milligrams. This will take place for 6 weeks for a fingernail infection, and 12 weeks for a toenail infection. Lamisil is generally less costly than other antifungal medications.
Sporanox is prescribed due to its effectiveness to treat Candida infections and dermatophyte infection. This treatment tends to cost more for the patient.
Proximal subungual onychomycosis treatment may also involve fluconazole, which is also known as Diflucan. It is not used as often as other medications to treat this nail infection.
This agent will stop the growth of fungi and keeps the disease from spreading. It does not kill the fungi that are present. This is known as a fungistatic medication which stops growth, as opposed to a fungicide which kills the growth.
Diflucan is used to help stop the growth – so that the immune system can then take care of the rest. This is not usually the drug of choice among physicians, but the patients who are given the medication will take it until the infection is gone.