03 July 2018
TUESDAY, July 3, 2018 (HealthDay News) — A New York City woman who got a trendy “fish pedicure” may have lost a little more than the dead skin on her feet — she may have lost her toenails, too. So finds a case report published July 3 in the journal JAMA Dermatology. A dermatologist who treated the woman says the tiny “doctor fish” (Garra rufa) that feasted on the 20-something’s feet somehow triggered onychomadesis — a condition involving “a complete halt in nail plate production.” During a fish pedicure, people immerse their feet in warm water and let doctor fish eat away at dead skin. The procedures have become all the rage in recent years. “Being omnivores,” the fish “will eat human skin,” wrote case report author Dr. Shari Lipner, a dermatologist at Weill Cornell Medicine in New York City. In fact, one clinical trial found that doctor fish were a useful treatment for people with psoriasis — the fish ate away psoriatic skin but left healthier bits untouched, Lipner said in the report. However, routine use of the fish for pedicures is another matter, she said, and may often cause more harm than good. “First, tubs and fish cannot be adequately sanitized between people,” Lipner said, “with the same fish typically reused for several persons.” That raises the odds for infections transmitted between customers, and “several bacteria capable of causing disease in humans were isolated in batches of Garra rufa and waters from 24 fish spas,” she said. There have even been two recorded cases of serious staph infections tied to fish pedicures, Lipner noted. “Therefore, their use has been banned in at least 10 states in the United States,” she said. In the new case report, the young woman complained of six months of abnormal toenail growth. Despite being in good health with no prior history of nail disorders, some of her toenails showed a separation and gradual disappearance of the underlying nail bed. Lipner diagnosed onychomadesis — a not-uncommon condition that’s most often linked to underlying major illness or certain medications. Ruling those causes out, “to my knowledge this is the first case of onychomadesis associated with a fish pedicure,” she said. Just how the nibbling fish triggered onychomadesis “is unknown,” Lipner said, but “it is likely that direct trauma caused by fish biting multiple nail units causes a cessation in nail plate production.” One skin expert not involved with the case said the report raises cause for concern. “Chalk this one up to ‘not everything natural is good for you,'” said Dr. Doris Day, a dermatologist at Lenox Hill Hospital in New York City. “Unfortunately the water is sometimes contaminated with bacteria and other pathogens and the fish themselves can do more damage than good,” Day said. More information Find out more on keeping your pedicure healthy at the American Podiatric Medical Association.
23 March 2018
FRIDAY, March 23, 2018 (HealthDay News) — Piling on pounds is bad for your health from head to toe. So say Korean researchers, who report that unhealthy weight gain ups a person’s odds for disfiguring toenail fungal infections. In fact, people who are statistically obese have more than double the rate of the infection, known as onychomycosis, compared to slim people, the study of nearly 9 million adults found. Any unhealthy increase in weight was “associated with an increased incidence of onychomycosis,” concluded the team led by Dr. Ji Hyun Lee, of the Catholic University of Korea College of Medicine in Seoul. U.S. dermatologists said the finding isn’t surprising. “I definitely tend to see onychomycosis more in overweight patients and prediabetic and diabetic patients,” said Dr. Michele Green, a dermatologist at Lenox Hill Hospital in New York City. She noted that the infection is “extremely common.” It can also be “debilitating,” Green added, “since for some patients it can be very painful and lead to having other co-infections.” In advanced cases, onychomycosis also necessitates the use of painful medicinal injections around the nail bed. Dr. Victoria Sharon directs dermatologic surgery at Northwell Health in Great Neck, N.Y. She said some studies have estimated that up to a quarter of U.S. adults live with onychomycosis. “In the majority of cases, onychomycosis is not life-threatening and is often asymptomatic [symptomless], with patients being most bothered by the unsightly look of their nails,” Sharon noted. In the new study, Lee’s group examined the health records of millions of South Koreans over age 20. The researchers looked specifically at changes in the individuals’ weight between 2005 and 2012, as well as their incidence of onychomycosis. The study found that the odds of developing the toenail infection rose as weight increased. Among slim people — those with a body mass index (BMI) of 18.5 or lower — there were just 12.5 cases of the infection per 1,000 people. But among the statistically obese — people with a BMI of 30 or more — that number rose to 29.7 cases per 1,000, more than a doubling of the rate. Of course, the best way to reduce your risk of onychomycosis is to stay slim, or slim down if you’re already overweight. But Green stressed that there are effective treatments if the fungal infection strikes. “The best treatments start when you catch it early and you can use topicals such as Penlac nail lacquer or Jublia,” she said. “More severe cases require oral antifungal drugs such as Lamisil for at least three months to treat these nail fungal infections.” The new study was published in the March issue of the Journal of the American Academy of Dermatology. More information Find out more about onychomycosis at the American Academy of Dermatology.