[Mycoses and diabetes]

Generally, diabetic patients are more susceptible to skin infections. Although the overall incidence of skin mycoses in diabetics is not higher as compared with healthy population, diabetics seem to suffer from certain types of mycoses more frequently. They are not only tinea pedum and onychomycosis, but also candidoses (especially candidal balanitis). In older patients, sole tinea is often overlooked. Nevertheless, it impairs integrity of skin and lets in bacterial infections causing diabetic foot and aggravates nail infections. Onychomycosis in diabetics is far from being a cosmetic problem only. On the contrary, it is potentially a very dangerous disease. Hypertrophic and deformed nails damage adjacent skin and their pressure can result in decubital ulceration of neighbouring fingers or nail beds. This condition can even lead to finger gangrene. Therapy of onychomycosis in diabetics and seniors should be specific: the most effective therapeutic procedure proved to be the combination of systemic treatment with terbinafine and atraumatic chemical ablation with subsequent local treatment.