Picture of Ringworm Tinea Unguium (Onychomycosis)
Ringworm - Tinea unguium (fungal infection of the nails) is somewhat uncommon during childhood. After puberty, its frequency increases with age. Usually, onychomycosis is associated with tinea pedis. Fungal culture of the nails is sometimes difficult but extremely important in confirming the diagnosis. Onychomycosis is the most difficult of the superficial fungal infections to treat because the nail plate is not penetrated by (most) topically applied agents. Systemic antifungal agents such as itraconazole and terbinafine appear effective in the treatment of onychomycosis. The illustrations show infection with dermatophytes. Note the distortion of nail plates. Infection by dermatophytes usually proceeds in a distal-toproximal direction. Infection of nails by C. albicans is different in that it is more acute (frequently purulent) and tends first to involve the lateral and proximal nail folds.
Source: Color Atlas of Pediatric Dermatology
Samuel Weinberg, Neil S. Prose, Leonard Kristal
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