
One of the most prevalent dermatological conditions affecting both fingernails and toenails is nail infections, often known as onychopathies. These infections, which can result in pain, discomfort, discolouration, deformity, and functional impairment, can be caused by bacterial, viral, or fungal pathogens. Onychomycosis is the most common type, making up almost half of all nail problems worldwide. Although non-dermatophyte moulds and Candida species may also play a role, dermatophytes such as Trichophyton rubrum and Trichophyton mentagrophytes are the leading causes of onychomycosis. Thickening, brittleness, discolouration, and onycholysis (separation of the nail from the bed) are caused by the pathophysiology of keratin colonisation and degradation inside the nail plate. Paronychia, or green nail syndrome, can be caused by bacterial infections, particularly those due to Pseudomonas aeruginosa and Staphylococcus aureus. On the other hand, the nail unit may also be affected by viral infections, such as periungual warts caused by the human papillomavirus (HPV). Clinical evaluation is used to establish the diagnosis, which is then verified by laboratory tests such as fungal culture, KOH microscopy, histological analysis, and polymerase chain reaction (PCR) methods for pathogen identification. Topical and systemic antifungal or antibacterial medications are used in treatment; refractory instances are treated with surgery or laser therapy. Reducing recurrence requires preventive measures, such as maintaining good nail hygiene, avoiding prolonged exposure to moisture, and promptly treating minor nail injuries. A thorough understanding of the causes and treatment of nail infections ensures effective treatment and better patient outcomes.
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