▲The doctor reminded that you should avoid wearing shoes that are too small or too narrow in the last and new shoes when climbing or walking for a long time, so as not to wear your feet and feel uncomfortable;

(Photo credit: shutterstock)

Text / Zhou Wanyi

Xiaoshan decided to challenge Baiyue under the warm invitation of her friends. On the day of climbing, she was very happy to climb the mountain wearing her newly bought hiking shoes. A week later, the nails were hollowed out, and I was diagnosed with onychomycosis in a general clinic. After taking oral antifungal drugs for 3 months, it still didn't work, so I rushed to the dermatology department for treatment.

▲Figure 1: In addition to the symmetrical white nail bed peeling on the outside of the big toe nail, there is also reddish-brown chronic subnail hemorrhage.

(Photo provided by Zhou Wanyi)

Onychomycosis is often misdiagnosed when nail bed peeling occurs

After the examination, it was found that in addition to the stripped nail bed of Xiaoshan's big toe, there were reddish-brown old blood clots inside (Figure 2), but in fact there was no onychomycosis. After one treatment, the toenail returns to its former health and beauty (Figure 3).

Please read on...

Bleeding under the nail is very common in dermatology clinics. If it is an acute bleeding caused by being hit by something, most of them can recover normally after drilling a hole with a special instrument to squeeze out the blood immediately; The hole cannot be squeezed out either.

In addition, like Xiaoshan, wearing too tight shoes, closed shoes, or high heels, after walking for too long or climbing mountains, the nails produce chronic subnail bleeding.

Under normal circumstances, the toenail and the underlying nail bed are sticky, but when the nail bleeds, this space will be opened by blood or blood clots. After the blood clot subsides, the nail will often be empty, forming nail bed peeling (commonly known as empty nail disease) ) status.

Nail bed peeling is often misdiagnosed as onychomycosis. No matter whether patients take oral or topical antifungal drugs, they will not be effective, and it will only increase the risk of unnecessary oral drugs.

▲Figure 2: There are thick horny accumulations and blood clots on the nail bed.

(Photo provided by Zhou Wanyi)

▲Figure 3: The normal toenail after nail surface treatment.

(Photo provided by Zhou Wanyi)

Moderate surface treatment can restore smoothly

The easiest way is to have a doctor who specializes in toenails remove the blood clots, and then do a moderate nail surface treatment on the nail bed. Most of them can recover smoothly after one treatment.

It is recommended that people usually choose shoes, and try not to choose a version that is too small or too narrow, especially for friends who play sports or climb mountains. When sports require braking or going downhill, the big toe often Bear the brunt, if the shoes are not suitable, it is easy to cause bleeding under the toenail, so don't be careless.

When choosing shoes, the distance between the big toe and the front should be at least 1 cm, and the toes must be able to move freely like playing a piano.

If you want to travel abroad, climb mountains or take a long road, try to avoid wearing new shoes, so as not to wear your feet and feel uncomfortable, and you can't change them in time.

When Xiaoshan returned to the clinic, she looked at her toenails which had finally returned to normal, and shouted: "I will never dare to climb mountains with new shoes again!"

(The author is the dean of Zhenxin Dermatology Clinic)

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keywords

  • Onychomycosis

  • health care

  • Antifungals

  • nail

  • nail bed peeling

  • Empty armor

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