skin infection on foot

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  Ringworm of the nails(tinea unguium)

 Diagnosis 

Diagnosis can only be made with certainty by    finding the fungus in shavings from the nails. These should be soaked. in a small quantity of 5% potassium hydroxide for 24 hours and examined microscopically, and the examination must be repeated several times before confidence can be felt, in a negative result. The diseases liable to be confused with ringworm of the nails arc psoriasis. lichen planus  and the various types of nail dystrophy.

Treatment- 

This is with griseofulvin. Higher doses than normal have to be given beginning in an adult, with 8 tablets a day for the first 2 weeks and reducing this to 6 for the next four weeks and then to 4 until all the abnormal nail has been shed and replaced by normal new nail. In the case of the finger nails this may take from six to nine months, if the infection has reached. backward as far as the nail fold, since infected nail grows more slowly than normal nail. Local treatment should also be given to any coexisting skin involvement. Growth is so slow in the toe-nails that the best procedure is to remove the nails and give griseofulvin until the new nails have completely regrown. The rate of growth is greatly increased by removal of the infected nail and the total period of treatment considerably shortened.