Infections of the foot

Question 1

What are the causes of fungal nail infections

Answer 1

The same fungi that cause athlete’s foot can spread into the nails if such a skin infection is not treated early.

Question 2

What are the symptoms of fungal nail infections (5)

Answer 2

1. The tip/edge of the nail turns white/yellow and thickens
2. The infection spreads from the top of the nail towards the base of the nail
3. Bits of dead skin and nail collect under the nail
4. The nail becomes scaly, sometimes thicker in parts and the shape distorted
5. Finally it becomes brittle and breaks off

Question 3

How are fungal nail infections treated (6)

Answer 3

1. Amorolfine hydrochloride5% nail lacquer
2. used once a week for a minimum of six months for fingernails, or until the infection has cleared.
3. Fungal nail infections of the foot may take nine to twelve months to treat.
4. Other options include nail-softening treatment kits that contain a urea paste, plasters and a scraping device.
5. The paste softens the infected parts of the nail, allowing them to be scraped away so they can be gradually treated with an antifungal and be replaced with healthy nail.
6. An alternative treatment lowers the pH of the nail, creating an environment that is hostile to fungal growth.

Question 4

What patients need referral for fungal nail infections (9)

Answer 4

1. Anyone under the age of 18 years
2. Pregnant or breast-feeding women
3. Those who have had a hypersensitivity reaction to amorolfine or any other ingredients contained in the product in the past
4. Those who have moderately or severely damaged or infected nails
5. infection at the base of the nail
6. there are dark stripes running down the nail
7. Those who have other nail conditions that are not caused by fungal nail infections
8. Those with diabetes or poor blood circulation
9. There are more than 2 infected nails in total

Question 5

What is verrucas (2)

Answer 5

1. caused by the human papilloma virus (HPV) that causes warts.
2. This in turn increases the amount of keratin that the skin produces which causes a hard growth to appear on the skin.

Question 6

What causes verrucas (3)

Answer 6

1. Verrucas are easily transferred from one person to another through contact with an infected individual/contaminated surface, such as the floor of a changing room, especially if wet.
2. The virus can also be spread through the sharing of towels, socks and shoes.

Question 7

What are the symptoms of verrucas (3)

Answer 7

1. a rough, flat area of skin, often with black dots in the centre
2. these are blood clots/dried blood in tiny blood vessels, not the root or ‘core’ that needs to be removed.
3. Verrucas can be painful, especially when walking or squeezed, and sometimes can form in clusters.

Question 8

How are verrucas treated (4)

Answer 8

1. to cover the verrucas with padding and leave it to resolve on its own, since treatment can be long and painful.
2. There are topical liquids, gels and ointments available for treating verrucas
3. most containsalicylic acid,often in combination with lactic acid.
4. Verruca treatment, as with warts, can take many weeks/months to work, and some may need to be removed by a chiropodist or a GP, if this service is available, through the application of nitrogen freezing (form of cold therapy known as cryotherapy).

Question 9

What causes athletes’ foot (5)

Answer 9

1. caused by a fungus which thrives on warm, moist conditions to grow, for example, between the toes.
2. do not dry their feet adequately
3. wear shoes that do not allow the foot to breathe
4. share socks, shoes and towels
5. those with certain health conditions such as diabetes and impaired immune function.

Question 10

What are the symptoms of athlete’s foot (2)

Answer 10

1. Itchy, peeling rash that is sore and most often starts in-between the toes.
2. In severe cases the affected skin can crack and bleed

Question 11

What treatment is there for athlete’s foot (7)

Answer 11

1. imidazole antifungals (miconazole, clotrimazole)
2. non-imadazole antifungal such as terbinafine.
3. Treatments are available in a variety of different forms, including powders, creams, ointments, liquids and sprays.
4. Using a cream or spray for the foot itself, and a spray or powder for the shoes, socks or hosiery, is an effective combination to eradicate the fungus and its spores.
5. Where the skin is also inflamed, a combination product containing hydrocortisone and an antifungal may be of benefit for up to seven days.
6. The product should be applied to the rash directly and the surrounding area as the fungus can spread to other areas of the foot easily.
7. Treatment should continue even until the rash has cleared and for a further period depending on the treatment used, to prevent it coming back.