Fungal infections: community nursing approaches to skin and nail care.

Dermatophytes (ringworms) are possibly the most prevalent causes of human infection globally. At least 40 dermatophyte species infect humans. For example, onychomycosis, which is responsible for about half of abnormal nails, may: produce ridging, ingrown nails, bleeding and nail loss; make walking painful; and facilitate secondary bacterial infections. Several diseases increase the risk of onychomycosis caused by dermatophytes, including knee osteoarthritis and poorly controlled diabetes. This article focuses on nursing approaches to managing skin and nail dermatophyte infections. Topical antifungals are generally the first-line treatment for tinea corporis, cruris and pedis. Oral antifungals may be appropriate for tinea capitis, onychomycosis, extensive skin infections or if topical treatment does not resolve the infection. Antifungal resistance is becoming more common. However, community nurses should address poor adherence and other possible causes of treatment failure before assuming antifungal resistance. Community nurses should also ensure that patients are diagnosed and treated rapidly, and suggest lifestyle changes that reduce the risk of antifungal failure, infection and relapse.