Nail bed infections of the feet or fingernails are no longer an uncommon phenomenon, especially if the correct footwear is not donned during long hours at work or even when footwear is simply worn for too long. The moist and dark interiors help propagate the growth of various fungal and yeast-like microorganisms, many of which go on to develop into Athlete’s foot disorder.
One such commonly isolated fungus species in human nail infections is trichophyton rubrum. Trichophyton rubrum is the complex name associated by scientists with a dermatophytic kind of fungus. It belongs to Ascomycota phylum and is termed an anthrophilic, saprotroph. This creature is commonly found colonizing upper dead skin layers, and has recently been established in scientific literature as the single most commonly known causative agent behind Athlete’s foot, jock itch, and even the ringworm disease. First discovered in 1845, the rubrum complex comprises of many patterned morphotypes that include sub-species, such as T. megninii, T. gourvili, and T. violaceum.
How Trichophyton rubrum is Transmitted
Now that we’ve established that the T. rubrum phylum of dermatophytes are probably one that most people will want to keep themselves away from, it’s worth being aware of the various ways in which this infection can be transmitted to you. The species is well-known for its affinity for hairless skin. Hence, it has rarely been isolated from areas of hairy skin. Infected towels, clothing, and linen surrounded with heat, high humidity levels, perspiration, and friction within the clothes are all possible means of transmission. Patients with diabetes mellitus and obesity are even more prone to developing such infections, which can be painful and often very debilitating. The main way to prevent transmission would be to adapt higher standards of hygiene and a healthy lifestyle.
Regularly changing clothes, hand washing, and infection control are essential to avoid yourself or your family catching the infection. Once a family member has caught the infection, it very easily spreads by touch and direct contact as it a skin-surface infection. Sharing the same utensils, food items, and clothes with an infected person can lead to the same inter-familial transmission. One should also avoid barefoot walking on damp surfaces, especially in communal areas where these bugs often breed.
Pathological Appearances of the Nailbed Infection
The pathological appearance of nail bed infections can vary quite drastically. Also, it is important to note here that all Trichophyton rubrum associated infections will not necessarily affect the nails of your feet or fingers. The groin is a common site of jock itch, for instance. Along with the commonly found E. floccosum in the groin, reddish-brown lesions appearing in this region may be due to rubrum infections. The trunk and upper thigh are commonly affected by these lesions that tend to have a raised-edge border. When T. rubrum infects the nails, it is also known as onchomycosis. When the skin of the hands is infected, Tinea manuum is diagnosed, characterized by spread of infection unilaterally in the palms.
The other most common lesion of T. rubrum is on the foot; that is the all-famous Athlete’s foot disorder. Chronic Tinea pedis leads to the appearance of skin on the foot in a moccasin-patterned manner. All of the foot will form scaly, white patches, and the infection will usually equally affect both feet. Multiple sites of infection are likely to exist in Tinea pedis. These may be cured spontaneously without treatment or require topical antifungal application. It is most commonly found in adults and rare to see Tinea pedis by T. rubrum in children.
Treatment for Rubrum Infection
The severity, depth and locus of the trichophyton rubrum infection greatly impact how long the treatment process will take and what kind of drugs your practitioner may prescribe you for the same and is the same for trichophyton mentagrophytes treatment and trichophyton tonsurans treatment. Anti-fungal gels, creams, and topical agents are usually the first mode of treatment for mild to moderate infections. Only in cases of severe and systemically spread nailbed infection will your practitioner opt for a tablet prescription as such. It is always wise to stick to your doctor’s recommendation when it comes to such treatment. For example, if the infection resembles Tinea pedis, miconazoles nitrates, tolnaftate, clotrimazole, butenafine hydrochloride, terbinafine hydrochloride, or undecylenic acids will be effective in quick resolution.
For infections that have invaded deeply and do not resolve after primary therapy, doctors may prescribe an oral ketaconazole drug as this will inhibit the wider spread of the T. rubrum species. Furthermore, laboratory and clinical trial testing has shown that this species has a greater vulnerability to this drug than others. Fluconazole, itraconazole, and oral terbinafines are also good at resolving the infection. In fact, Tinea corporis and cruris caused by the T. rubrum species has been successfully resolved by topical creams like naftifine and terbinafine as well. Photodynamic treatments, photo-activation of green Bengal dyes, and laser irradiation are other techniques used in state-of-the-art medical facilities for overnight resolution of the issue. However, the cost of such treatment is quite high and not necessarily called for.
Furthermore, Tinea unguium is a condition of nailbed infection that can be more difficult to treat as the cream is required to penetrate into your nail bed. Griselfuvin used systemically helps in this case. However, treatment can take up to a year and not necessarily be successful in some cases. Intermittent use of pulse therapy is also popular, in combination with drugs.
In general, you can expect treatment of a deep infection to take up to 8 weeks to be completely cured. Rarely will a fungal infection leave deep scars at the site of the infection of cause permanent loss of nails. Minimal stress and pressure should be applied to the area till fully healed, avoiding direct application of trauma or blows during treatment to the locality. Occlusal dressing is commonly done by your GP. The nailplate may be temporarily softened by use of tolnaftate agents to promote entry of the treatment anti-fungal drug into the dermal layer where the infectious agents lie.
Hence, it is very important to be careful of acquiring Athlete’s foot infection and any kind of fungus at all on your body.