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zannino36403 April 23, 2023 Comment

Owing to the high recurrence rate of fungal nail infections, pharmacy professionals should be able to advise patients on effective treatment and preventative and appropriate self-care strategies to avoid re-infection.

. An increased incidence among older people may be attributed to multiple factors, including reduced peripheral circulation, diabetes, inactivity, relative immunosuppression, and reduced nail growth and quality

This article will cover the causes, types and treatment of OM, practical information to help guide patient consultations and when to refer to podiatry.

Fungal Nail Infection Causes, Symptoms And Treatment

Figure 1 shows the composition of the nail, including the nail plate (the visible part of the nail), nail bed (the skin under the nail) and nail matrix.

The nail plate and nail bed are joined by layers of hard, translucent, keratinised cells. The nail bed and nail matrix are vascular components of the nail, with nail cells located within the nail matrix where the nail plate is formed. The thickness of the nail plate determines the length of the matrix [7], [8] .

Damage to the nail structure can affect nail growth, shape, size and, consequently, predispose the nail to infection. OM can invade any part of the nail but typically enters the nail’s free edge, sulci or damaged cuticles (see Figure 2).

Fungal Nail Infection

Where OM infects the area underneath the nail plate, the infection produces a thick hyperkeratotic nodule that contains clusters of branching filaments (hyphae) called dermatophytoma (see Photoguide: A)

. The abnormal thickness of the nail may lead to soft tissue breakdown and/or infection resulting in inflamed subcutaneous tissue (cellulitis), ulceration in the nail bed (subungual ulceration) and/or bone infection (osteomyelitis)

The most common type of OM is distal lateral subungual onychomycosis (DLSO)(see Photoguide: B). It is characterised by build-up of soft yellow keratin between the nail plate and nail bed (subungual hyperkeratosis), detachment of the nail from the nail bed (onychosis) and skin infection around the nail (paronychia). DLSO spreads proximally to the nail matrix

Fungal Nail Infections

Cases of white superficial onychomycosis (see Photoguide: C) are characterised by distinct white ‘islands’ on the nail surface, which gradually spread to the entire nail, causing it to become soft and crumbly

White milky patches without subungual hyperkeratosis (build of keratin underneath the nail) indicateendonyx onychomycosis (EO) (see Photoguide: D). Pitting is involved with splitting of the nails. EO usually affects fingernails

Affecting fingernails and toenails, proximal subungual onychomycosis (PSO)(see Photoguide: E) is frequently found in, but not unique to, patients with HIV. The fungal infection begins at the cuticle and the nail fold before penetrating the nail plate. PSO is characterised by white discoloration that usually includes paronychia with some discharge

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The most advanced type of OMis total dystrophic onychomycosis (see Photoguide: F), which invades the nail plate, nail bed and nail matrix causing severe nail dystrophy. There can be chronic swelling at the distal phalanx with the affected nail appearing thickened, yellow-brown in colour and severely deformed

Despite OM having distinct clinical features, around half of nail dystrophy cases are caused by fungal infection and, therefore, clinical examination alone is rarely sufficient to diagnose OM

Characteristics are shared with other nail diseases, such as psoriasis, lichen planus or bacterial infections (see Table 1). In addition to examining the nail(s) affected, pharmacists should ask the patient the following questions to help establish a diagnosis

How To Treat Toenail Fungus: Effective Remedies & Prevention

Ideally, OM should be confirmed by direct microscopy and cultures to eliminate non-infective differential diagnosis, to identify mixed infections and to detect resistant OM

The British Association of Dermatologists (BAD) supports laboratory investigation prior to commencing oral treatment, which is in support of guidance from Public Health England (PHE)

. Guidance for use of topical medications for DLSO is less clear and although investigations would present good practice, these treatments have minimal associated risks compared with oral treatment. However, incomplete sample collection could have a major impact on false negatives. Time constraints and continuity in working patterns should be considered as culture and microscopy results may take 2–6 weeks to come back.

Best Ways To Treat A Nail Fungus

Proximal nail bed whiteness and distal nail bed red/pink/brown discolouration (called half and half nails); absent lunula and tiny blood clots under the nail (splinter haemorrhages)

On examination, pharmacists should consider the following factors and patient groups and it may be necessary to refer the patient to a podiatrist or their GP:

The management of OM depends on the type, extent and severity of nail involvement, symptoms and pre-existing conditions. The aim of treatment is to eradicate the pathogen, restore the nail and prevent re-infection. OM is challenging to treat and affected nails may never return to normal as the infection may have caused permanent damage.

Laser Treatment Faqs

The compact and hard nature of the nail anatomy means topical drug penetration can be poor, with the concentration reducing by 1, 000 times from the outer to inner areas

The only topical nail lacquer available in the UK for over-the-counter (OTC) purchase is amorolfine. It is licensed for mild (not more than two nails affected) DLSO and patients aged 18 years or over. Amorolfine is a broad-spectrum synthetic fungicidal with high activity against dermatophytes, as well as other fungi, yeasts and moulds. It is available as a 5% lacquer that should be applied once or twice per week

Before application, patients should be advised to file down the affected nail surfaces using a single-use nail file, clean the nail surface with the supplied swab and dry the nail surface

Nail Fungus: Diagnosis And Treatment

. Patients should be reminded that this process should be repeated for sequential treatments; a step that is commonly missed out. Sterile cotton buds should be used to apply the lacquer to avoid contamination.

Amorolfine maintains clinical efficacy in the nail for 14 days after treatment; however, twice-weekly application results in better outcomes compared with once-weekly application (71% versus 76% mycological cure)

. Compliance is essential; pharmacists should encourage patients to continue the treatment, given the prolonged treatment duration of 6–12 months. Side effects are rare and limited to nail disorders (e.g. discolouration, and broken and brittle nails), which may be related to OM itself.

Nail Fungal Infection: Causes, Treatment, And Symptoms

. Tioconazole is an imidazole derivative with a broad spectrum of action against dermatophyte and yeast-like fungal species. It is available as a 283mg/mL medicated nail lacquer and is applied to affected nails twice a day. Treatment duration ranges from 6–12 months depending on the pathogen, the severity and the location of the infection. Common side effects include mild and transient local irritation that usually presents during the first week of treatment

For adults with confirmed OM, systemic therapy is advised when self-care strategies with or without topical therapy are unsuccessful or inappropriate. A recent Cochrane systematic review of oral antifungal treatments for toenail OM in more than 10, 000 patients found high-quality evidence indicating that terbinafine and azoles were effective treatments for mycological and clinical cure compared with placebo

Terbinafine and itraconazole are considered the mainstay of oral therapy for OM, although terbinafine is generally preferred over itraconazole owing to better cure rates compared with azole in toenail OM

Top Home Remedies To Treat Toenail Fungus

200mg once daily for 3 months, then 200mg twice daily for 7 days, repeated at 21 days. Fingers require two courses, toes require three courses and persistent infections require an additional course of treatment

Abdominal pain, agitation, confusion, depression, diarrhoea, dizziness, dyspepsia, fatigue, glossitis, hepatotoxicity, impaired hearing, kidney failure, leucopenia, menstrual disturbances, nausea, peripheral neuropathy, photosensitivity, rash, sleep disturbances, systemic lupus erythematosus, taste disturbances, vomiting

Topical and systematic combination therapy may provide synergistic antimicrobial activity. The BAD recommends this for patients who have responded poorly to topical treatment alone

Nail Fungus Frequently Asked Questions

. Amorolfine 5% nail lacquer with systemic antifungals has been supported by a meta-analysis and systematic review to provide a higher percentage of total OM clearance compared with monotherapy of systemic terbinafine, without an increase in adverse effects

Photodynamic therapy combines light irradiation and a photosensitising drug to cause destruction of selected cells. Laser therapies, such as neodymiumyttrium-aluminum-garnet and low-level laser, are aimed to selectively inhibit fungal growth

. These alternative therapies may be appropriate because they are selective to local infection and avoid systemic side effects; however, robust data are scarce

Explainer: Why Do We Get Fungal Nail Infections And How Can We Treat Them?

According to the National Institute for Health and Care Excellence (NICE), patients require advice around foot care in order to avoid and minimise exposure to situations that predispose individuals to OM (e.g. prolonged exposure to damp conditions, occlusive footwear, prevention of damaged nails and to ensure meticulous hygiene of the affected foot)

Treatment must include a combination of proper hygiene and foot care as the risk of reinfection is high. Self-care to prevent infection should be stringently practiced until the fungus is eradicated, which may take up to 18 months

Pharmacists should advise patients on nail care, washing and drying feet daily, using the correct footwear and encouraging the use of antifungal powder to help keep shoes pathogen free. See Box for important self-care messages.

Fungal Nail Laser

Before initiating topical or oral therapy, patients should ideally be referred to a podiatrist for nail trimming and debridement. This assists with removing as much fungus as possible and improves topical drug penetration. Debridement alone cannot be recommended for the treatment of OM; patients using a combination of debridement and topical nail lacquer have shown a significant improvement in mycological cure compared with debridement only

. Patients with nail trauma owing to footwear, dystrophic toenails affecting

cartier nail bracelet original

zannino36403 April 22, 2023 Comment

To authenticate Cartier Juste un Clou bracelet Begin by inspecting the overall appearance followed by the metal quality. Then check the stamping, as well as the diamond. Don't forget to analyze the box too. Finish off your authentication process by checking the packaging.

While it may appear to look like "just a nail, " Cartier's Juste un Clou bracelet has been coveted for decades for its iconic design. You should inspect the metal once you have a clear understanding of its weight. Is there a test for 18K gold? Is the quality of the gems comparable to that of Cartier? Is the bracelet's weight appropriate for its size? Is the order of the serial numbers correct?

The distinctions between the two sizes of Juste un Clou bracelets—the little and the original—are also worth noting. The little bracelet is pliable, making it easy to put on, while the Juste un Clou bracelet's original size includes a hinged closing.

Cartier Rose Gold Diamond Juste Un Clou Bracelet Small Model 18k 16

Cartier does not cut corners when creating its jewelry; it only uses high-quality metals such as gold and platinum. These are hefty metals, and a bracelet stamped with the 750 material hallmark indicates that it is made up of 75% gold. Cartier Juste Un Clou bracelets typically weigh at least 33.4 grams, but if the bracelet has diamonds, it should weigh even more. The little model in 18K white gold with 0.54 carats of diamonds, for example, weighs 34.4 grams. Any bracelet lighter than this is almost certainly a counterfeit.

Any evidence of discoloration or flaking metal should also be considered a red flag. Furthermore, if another hue can be seen behind the surface, the bracelet is a fake. Furthermore, Cartier is known for its meticulous attention to detail, so if the alignments, closures, or other elements appear to be off, you're getting a fake. (Check Hermes Clic H Bracelet for similar issues)

Real Cartier jewelry has a clear mark with consistent spacing and precise writing, just as mentioned on their official website. Misspellings and a font that isn't cursive should make you suspicious, while misspellings and a font that isn't cursive should raise your suspicions. Aside from having the appropriate metal kind and serial number, the stamping's position is also critical.

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The Cartier stamp can be seen on the back of genuine Cartier bracelets. Also, take note of the measurement; Cartier's rings and bracelets are measured in millimeters. Keep in mind that these stampings must be imprinted on the bracelets; otherwise, you're buying a fake.

If your Cartier Just Un Clou bracelet features diamonds, the brand chose ones with a high clarity range, which means they don't have apparent inclusions to the human eye. You can still inspect for contained gems with a loupe lens. Colorless stones should be well-set, well-spaced, and of equal size.

Counterfeiters are famous for not accurately replicating fonts, and this is no exception: the letters on the real box are rounded and thick, whereas the fake lettering is deformed and shallow. Instead of being this pale, the symbols should be vivid and golden.

Cartier Juste Un Clou Bracelet

Even the box of a genuine Cartier bracelet might help you spot a fake. The logo is placed on the top of the outer boxes, while the logo is imprinted on the inside of the lids of the inner boxes. The internal fabric, which is either white cotton or black satin, is also a clue.

You may begin the authentication process as soon as you receive your bracelet: Cartier's attention to detail is unmatched, with textured backgrounds and rich, bright letters. The background of the replica box, on the other hand, is smooth and textureless, and the lettering is much larger and thinner. The difference may also be seen in the way the counterfeiters braided the handle; it's considerably smaller and matte.

Cartier's legendary Juste un Clou bracelets, which are at the top of the list, are the best jewelry purchase that well-informed shoppers can make right now. They're in high demand and are worth almost 106 percent of their original price.

Cartier Juste Un Clou Diamond Rose Gold Nail Bangle Bracelet At 1stdibs

Juste Un Clou ('Just a Nail') is Cartier's most recent ring and bracelet series. The rugged design of these classic pieces of jewelry was designed in the 1970s when it came to reflect the "rebellious spirit and raw energy of New York City" of the period.

Still, looking for professional help? We got your back! At , you can get your Cartier bracelet authenticated with the fastest turn-around time, all you need to do is reach out. Check it out: Cartier legit check.

Cartier Juste Un Clou Diamond Rose Gold Nail Bangle Bracelet At 1stdibs

nail shop in the mall

zannino36403 April 22, 2023 Comment

Nail salon at Northpark Mall reopens with social distancing, masks required Each morning lines of customers wait for workers to open the salon.

COVID-19 PANDEMIC. LEE SPA NAILS OPENED ITS DOORS LAST WEEKEND AND THE PHONES HAVE BEEN RINGING OFF THE HOOK. EACH MORNING LINES OF CUSTOMERS WAIT FOR WORKERS TO OPEN UP THE SALON. THE OWNER SAYS THEY ARE FOLLOWING CDC, AND THE GOVERNOR'S GUIDELINES TO ENSURE SAFETY. TEMPERATURES ARE CHECKED BEFORE ENTRY, AND EVERYONE IS REQUIRED TO WEAR A MASK AND WASH HANDS THROUGHOUT THEIR VISIT. THE WAITING AREA IS CLOSED... SO CUSTOMERS LINE UP OUTSIDE OF THE SALON. "SOCIAL DISTANCING OF 6 FEET APART. AS YOU CAN SEE THERE'S ORANGE MARKS THAT WE MARKED WHERE IT'S 6 FEET FROM CUSTOMER TO CUSTOMER. OUR PEDICURE CHAIRS IT'S EVERY OTHER ONE THAT'S GOING TO BE USED THAT IS MORE THAN 6 FEET APART." THE OWNER IS ASKING FOR CASH OR CASH APP PAYMENTS ONLY. IF YOU DON'T HAVE A MASK... THEY WILL PROVIDE ONE FOR YOU BEFORE YOU WALK IN. THE NAIL SALON AND MALL CLOSES AT 6PM. MISSISSI

Nail salons are polishing up safety measures to keep workers and customers safe during the COVID-19 pandemic. Lee Spa Nails in Northpark Mall opened its doors almost a week ago and the phones have been ringing off the hook.Each morning, lines of customers wait for workers to open the salon. Kristine Ho, owner of Lee Spa Nails, said they are following CDC and the governor’s guidelines to ensure workers and customers stay safe. Customer’s temperatures are checked before entry and everyone is required to wear a mask and wash hands throughout their visit.“We’re doing one customer per employee. The mall has helped us by opening a waiting area outside. We do mainly appointments, but we do take some walk-ins in case an appointment cancels, ” Ho said.The waiting area is closed, so customers must line up outside of the business. “We’re making sure everyone is social distancing 6 feet apart. There are orange marks on the floor that make sure customers stay 6 feet away from each other. Our pedicure stations are set up so every other chair is used. That is more than 6 feet apart, ” Ho said. Ho said if customers do not have a mask, the shop will provide one.The owner is asking for cash or cash app payments only. The nail salon and mall close at 6 p.m.

Best Nail Salon Shop In Los Angeles

Lee Spa Nails in Northpark Mall opened its doors almost a week ago and the phones have been ringing off the hook.

Kristine Ho, owner of Lee Spa Nails, said they are following CDC and the governor’s guidelines to ensure workers and customers stay safe.

“We’re doing one customer per employee. The mall has helped us by opening a waiting area outside. We do mainly appointments, but we do take some walk-ins in case an appointment cancels, ” Ho said.

Changes At Shops At Worthington Place May Portend Future For Malls

“We’re making sure everyone is social distancing 6 feet apart. There are orange marks on the floor that make sure customers stay 6 feet away from each other. Our pedicure stations are set up so every other chair is used. That is more than 6 feet apart, ” Ho said.During the COVID-19 outbreak, however, Nguyen’s regulars grew accustomed to more sporadic appointments — or none at all — as the pandemic caused capacity restrictions and temporary closures. Michigan nail salons were mandated to close on March 17, 2020, to help slow the spread of COVID-19, and were allowed to reopen again on June 15. Similar to other businesses in the beauty industry, nail salons are typically limited to indoor settings.

Along with customer hesitation to resume in-person activities or a loss of disposable income, or both, the beauty industry found itself among a unique sector of small businesses harmed by the pandemic.

In the first five months of the pandemic lockdowns last year, the founder of London-based nail polish retailer Nails.INC told Harper’s Bazaar that the company’s online sales increased 200 percent and U.S. retail sales were up 125 percent compared to the previous year.

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“They are used to living their lives without their nails done, ” said Nguyen, who hopes it’s a slow re-emergence to nail routines instead of a long-term trend. “Business has been slowing down. Even though the vaccine came out, I think people are still getting used to getting their nails done again.”

Nguyen started working for her cousin at Le Nails in 2007, and has owned the salon since 2012. The 1, 000-square-foot shop inside The Crossroads mall in Portage has been hit hard by COVID-19 restrictions. The store is currently limited to about six customers at a time compared to about 20 customers at once pre-pandemic.

“There is lots of extra cleaning we have to do before every customer comes in, so it takes a bit longer, ” Nguyen said. “There is a very slow motion to what we have to do and we cannot have someone sitting and waiting.”

Cosmo Nail Lounge Grand Opening At North Point Mall Introduces Atomy Brand Skin Care Line Cosmo Nail Lounge, Llc

Before the pandemic, 90 percent of Le Nails’ customers were walk-ins, which is much harder to accommodate under tight capacity limits. Mall operating hours also have been reduced by three hours to 11 a.m. to 7 p.m., Nguyen said.

Additional unemployment insurance benefits have also made it challenging to keep Le Nails staffed, said Nguyen, who had 10 employees pre-pandemic but now has three and works overtime with her husband to stay afloat.

“Me and my husband have to be there six or seven days a week, ” Nguyen said. “We have to be the workers and the managers, but we want to be working there to pay our rent and utilities. If I hire a manager or another worker to come in, then I will be making zero money.”

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Moreover, costs for supplies like personal protective equipment, rubbing alcohol and acetone needed to operate Le Nails skyrocketed during the pandemic, Nguyen said. She’s also buying more tools and supplies than before when she could sanitize and reuse some of them.

“It’s terrible, but it’s happening everywhere, ” Nguyen said. “I do understand that it is what it is, everyone is having to limit their capacity.”

The challenges don’t end there. Nguyen was able to access some federal small business relief funding, but she couldn’t have done it without the help of attorney Crystal Bui, who also serves as the president of the nonprofit Asian Community Outreach. Nguyen speaks English as a second language — an additional barrier to COVID-19 relief funding for minority-owned businesses — and reached out to Bui for help.

Nails La Bella

The New York Nail Salon Workers Association, which is part of the labor union Workers United, conducted a survey of more than 1, 000 members that found more than 81 percent felt excluded from government help during the pandemic, according to a report in MIT Technology Review.

Meanwhile, mall foot traffic has been decreasing, and Nguyen’s family is pushing her to look at other locations. But she has built up her business in the current location for so long that it would be hard to walk away, she said.

“The business you get inside of a mall is not the same as it was 10 years ago, ” Nguyen said. “Because I’ve been here about 15 years I do know lots of customers. They are like my friends and my family, my shop is like my kid, so I will try to hang on and hopefully we can get through until business is more normal.”

Color Nail Salon & Spa

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zannino36403 September 08, 2022 Comment

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