脚趾甲真菌感染通常可以归类为以下五个亚型之一：
远端ununcomchomycisois这是脚趾甲真菌感染的最常见形式，通常发生在指甲的一部分，靠近尖端和指甲的底面。指甲可能变稠，黄色或脆弱。
Endonyx Onychomycisois患有内chomycomycosis的人在脚趾甲层之间生长真菌。使用这种真菌，脚趾甲通常具有乳白色的白色，并且可能会被点缀或分裂。它们通常不会与指甲床变稠或分离。
近端白色ununcomchomycosisThis is a relatively uncommon form of toenail fungus, seen most often in people with weakened immune systems due to conditions such asHIV。The fungus enters the toenail through the cuticle and affects the part of the nail closer to the base, turning it a whitish color.
白色浅表性肿瘤病This is also a rare form of toenail fungus that can occur in people who are otherwise healthy. It’s caused by a specific fungus that grows on the superficial, or top, layers of the toenail. Symptoms include opaque, white areas on the toenail that may eventually spread to cover the entire nail. The nail becomes soft and crumbly in texture.
Candida Infection of the NailCandida is probably best known for causing阴道酵母菌感染, but the fungus also lives on the skin. When there’s a break in the skin around the nail, called the nail folds, candida may enter and cause inflammation and infection. The nail itself may thicken and separate from the nail bed if the infection persists. “This type of fungal infection tends to affect fingernails more than toenails,” Goad says.
Conditions That May Look Like Toenail Fungus
几种健康状况可能会影响脚趾甲的外观，并可能被误认为是脚趾甲真菌。
银屑病银屑病会在皮肤上引起红色，鳞片状的斑块。超过一半的皮肤牛皮癣的人也将其钉在指甲上。牛皮癣影响的脚趾甲和指甲可能厚，变色，易碎或松散。Sheth说：“有些人会因牛皮癣而发生指甲变化，如果它影响矩阵（生长板），那么这些变化是永久的。”
皮肤癌脚趾甲下方的变色位置可能是sign of melanoma, a potentially fatal form of skin cancer. Melanoma under a toenail usually looks like a brown or black streak or may appear similar to a bruise. Although this isn’t common, it’s also not rare, says Sheth. Her advice: “It’s always good to check it out.”
达尔疾病这种遗传疾病通常会引起淡黄色，潮湿的斑点。但是，根据Genetics Home参考，有些患有Darier疾病的人还具有指甲或脚趾甲的不规则性，例如用红色和白色条纹标记的指甲。Sheth指出，她从来没有活检come back with a diagnosis of Darier disease.
黄色指甲综合征众所周知，这种极少数情况会导致生长缓慢，增厚的黄色指甲，以及影响肺部和其他部位的异常，并在体内各个部位肿胀，according to the National Organization for Rare Disorders。综合征的确切原因尚不清楚。
斑秃根据Genetics Home的参考，这种自身免疫性疾病最常见的是头皮的圆形脱发斑块，尽管它也会影响身体的其他区域。脱发Areata也会影响指甲，这可能会变得粗糙或变形或形成白点。尽管很少见，但患有Areata的人会注意到指甲的变化，然后才能开始脱发。
Diagnosing and Treating Toenail Changes
If you notice changes in the appearance of your toenails,迅速看医生。If a fungal infection is suspected, a sample of the nail can be taken and analyzed by a lab to make a diagnosis. If the test comes back positive, an oral or topical antifungal medication may be prescribed to治疗真菌。Most antifungal medications are effective against most forms of toenail fungus, although treatment can take some time, in part because it’s hard to deliver any type of medication through the nail plate to the skin under the nail.
“Most of the time, the treatment requires the whole nail to grow out, which can take up to a year,” says Sheth. “Treatment needs to be consistent and long-term if it has any chance of working.”
If the test comes back negative for fungus, your doctor may begin investigating other causes for the abnormal appearance of your toenails. Sometimes symptoms involving other parts of the body help point to a diagnosis.
例如，患有黄色指甲综合征的人可能会遇到腿部肿胀或呼吸问题。那些患有脱发的人可以看到自己的头发开始掉下来。
And, according to Goad, “With psoriasis, patches of red, scaly skin may be seen on the knees, elbows, and face, too. It’s usually not limited to just the toenails.”
Additional reporting by Susan Jara
