Abstract:
A set depth nail notcher for cutting a notch of predetermined depth in a nail plate comprising a handle having a smooth flat surface, a longitudinal cutting edge protruding from the smooth flat surface to a height equal to the predetermined depth of the notch. A method for treating nail, especially toenail, fungus comprising cutting a notch to a predetermined depth in a nail or a toe of finger infected with fungus and applying a topical anti-fungal medication to the toe or finger through the notch.

Description:
BACKGROUND OF THE INVENTION 
     1. Field of the Invention 
     The present invention relates to a nail notcher for cutting a notch in a nail plate. The present invention also relates to a method for applying topical anti-fungal composition to fungus underneath a nail by applying the composition through the notch cut by the nail notcher of the present invention. 
     2. Background Discussion 
     A human&#39;s nail has a nail plate, which is a hard outer surface of dead cells and a nail bed below the nail plate. The nail plate is non-porous, whereas the nail bed is porous. There is soft flesh beneath the nail bed. The nail plate and the nail bed are relatively insensitive to pain. The underlying flesh is sensitive to pain. The nail plate, nail bed, and, in severe cases, the flesh below the nail bed can be infected by a wide variety of common fungi. Such fungi are responsible for nail infections, medically known as onychomycosis. Examples of onychomycosis are caused by fungi, such as  trichophyton mentagrophytes, candida albicans  or  trichophyton rubrum.  Other terms for onychomycosis are ringworm of nails or  tinea unguium.    
     It is difficult to treat such infections. Although the infections are highly localized, they are located in a part of the body which is difficult to reach. U.S. Pat. No. 5,573,786 discloses application of the composition for treating fungal diseases of the skin and mucus membrane with a small, pointy wooden stick or thin plastic porous plastic stick, or brush for treating large areas. Its Example 11 discloses onychomycosis treatment of a fingernail. However, the Example emphasizes that its preparation is suitable for treating superficial onychomycotic infections. In the case of infection of the nail bed, however, therapy must be carried out together with an oral antimycotic. U.S. Pat. No. 5,573,786 is incorporated herein by reference. 
     U.S. Pat. No. 5,696,105 discloses drilling holes in nails to apply anti-fungal medication, as an attempt to improve topical administration of medication. U.S. Pat. No. 5,696,105 also discloses other local measures to treat nail fungus include mechanical ablation of affected nail areas, or nail removal. U.S. Pat. No. 5,696,105 is incorporated herein by reference. U.S. Pat. No. 5,696,105 also discloses application of anti-fungal medication with a brush or an applicator tipped bottle. 
     Rather than directly applying topical anti-fungal medication, systemic treatments are also employed. However, such systemic treatments spread medication throughout the patient&#39;s body. Thus, the medicine is not concentrated in the infected area and may cause side-effects. 
     It would be desirable to provide a medication for treating nail fungus, particularly toenail fungus, which easily can be directly applied to the nail to result in effective, painless and bloodless treatment. 
     SUMMARY OF THE INVENTION 
     It is an object of the invention to provide a set depth nail notcher for cutting a notch in a toenail plate. 
     It is another object of the invention to provide a method for applying topical anti-fungal medication to an infected nail area through a notch cut in the nail plate by the set depth nail notcher of the present invention. 
     In its apparatus respects, the present invention relates to a set depth nail notcher for cutting a notch of predetermined depth in a fingernail or a toenail plate. The nail notcher comprises a handle having a smooth flat surface and a longitudinal cutting edge protruding from the smooth flat surface. The longitudinal cutting edge protrudes from the smooth flat surface to a height equal to the predetermined depth of the notch. If desired, the set depth nail notcher may provide a smooth convex surface rather than a smooth flat surface for a cutting edge to protrude therefrom. 
     In its method respects, the present invention involves a method for treating fingernail or toenail fungus comprising employing the above-described nail notcher to cut a notch to a predetermined depth in a fingernail or a toenail infected with fungus. Then a topical anti-fungal medication is applied to the nail bed of the finger or toe through the notch cut by the above-described nail notcher. As many as two or three notches may be employed on each nail. The method treats the infected nail to create a sterile antiseptic area proximal to the cuticle of the infected nail. Then the infected area grows distally away from the cuticle and is eventually trimmed off. The sterile area typically extend into the nail bed and may extend into the underlying flesh. 
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS 
     The present invention is illustrated by the below-described drawings, wherein like elements are labeled with like numerals. 
     FIG. 1 discloses a perspective bottom view of the first embodiment of the present invention. 
     FIG. 2 discloses a perspective top view of the embodiment of FIG.  1 . 
     FIG. 3 discloses a bottom view of the embodiment of FIG.  1 . 
     FIG. 4 discloses a side view of the embodiment of FIG.  1 . 
     FIG. 5 discloses a side view of a second embodiment of the present invention. 
     FIG. 6 discloses a front view of a third embodiment of the present invention. 
     FIG. 7 discloses a partial side view of a fourth embodiment of the present invention. 
     FIG. 8 discloses an infected toenail being treated according to the present invention. 
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS 
     FIG. 1 shows a first embodiment of a nail notcher  10  of the present invention. The nail notcher  10  has a handle  11  and a cutting (notching) edge  20 . The handle  11  has a smooth flat bottom surface  12  and a smooth, flat top surface  13  (FIG.  2 ). The cutting edge  20  protrudes from the smooth, flat bottom surface  12 . The cutting edge  20  may be attached to or integral with the handle  11 . 
     As shown in FIG. 3, the handle  11  has a first end  16  and a second end  18 . Likewise, the cutting edge  20  has a first end  22  and a second end  24 . The first end  22  of the cutting edge  20  may be at or adjacent the first end  16  of the handle  11 . The second end  24  of the cutting edge  20  may also be at or adjacent to the second end  18  of the handle  11 . FIG. 3 shows first end  22  of the cutting edge  20  being adjacent the first end  16  of the handle  11 . FIG. 3 also shows the second end  24  of the cutting edge  20  being adjacent the second end  18  of the handle  11 . (Of course, although not shown, the cutting edge ends may extend to the handle ends.) 
     The cutting edge  20  may contain a straight edge, abrasive or saw-toothed (notched) edge which is capable of penetrating the nail plate to expose the nail bed. In particular, the edge may be a sharp straight edge (as shown in FIG. 3) or round (as shown in FIG. 6) or serrated (as shown in FIG. 7) to expose the maximum area of the nail plate for maximum penetration of medication. The nail notcher  10  is capable of producing an exact depth notch limited by the depth of the cutting edge  20  and the smooth shoulders  14  on either side of the cutting edge  20 . For example, the cutting edge  20  may have a depth of about 1 to about 4 mm. 
     The nail notcher  10  is typically made of a material able to be autoclaved or sanitized. For example, the nail handle  11  may be made of metal or plastic. The cutting edge  20  is made of metal or any other material suitable for cutting. Also, combinations such as laminates of metal or plastic are possible for the handle  11 . The nail notcher  10  can either be a flat nail notcher  10  (as shown in FIGS. 1-4) or be a curved nail notcher  110  (the second embodiment as shown in FIG.  5 ). The nail notcher  10  typically has a surface length “L” (FIG. 3) of from about 1 to about 5 inches. The nail notcher  10  also generally has a width “W” of from generally about ⅜ inch to about 1 inch. In general, the nail notcher  10  is sized for easy gripping and use. Thus, it may be provided with additional features to facilitate gripping and use, such as clamps or protrusions from the upper surface or the nail handle may have contoured side edges, etc. 
     FIG. 5 shows a second embodiment of the nail notcher  110  of the present invention having a smooth continuous concave surface  112  from which a cutting edge  120  protrudes. Curved nail notcher  110  also has a convex top surface  113 . However, if desired, the top surface may be flat even though the opposed surface  112  is concave. 
     FIG. 6 shows a third embodiment of a nail notcher  210  of the present invention having a handle  11  as in the first embodiment of FIG. 1, but provided with a rounded cutting edge  220  having an abrasive surface of abrasive material conventionally employed with nail files or a rough metal surface. This embodiment is advantageous because it cuts a wider groove in the nail than would a sharp edge. This wide groove exposes more nail bed area for applying the topical medication. For example, the groove may be wider than it is deep. 
     FIG. 7 shows a side view of a fourth embodiment of the present invention of a nail notcher  310  having a handle  11  provided with a serrated cutting edge  320 . 
     Any of the above nail notchers may be employed to treat nail fungus. Typically, a nail notcher, such as nail notcher  10 , would be employed as follows. A patient or medical professional would rub the cutting edge of the nail notcher on a nail to abrade the nail plate to a prescribed depth. The abrading of the nail plate would occur by rubbing the surface of the nail with the nail notcher  10  until the cutting edge penetrates sufficiently deep into the nail for the smooth flat bottom surface  12  to contact the nail bed. In some instances, two or three notches may be made in the same nail for application of medication to multiple locations. In other instances, one notch may suffice. The notch (or notches) should expose the nail bed below the hard outer surface of the nail for subsequent application of topical anti-fungal medication which is then absorbed and, preferably, permeates the nail bed. The nail bed is the soft porous layer of the nail between the nail plate and the flesh below the nail. 
     The smooth flat bottom surface  12  prevents the cutting edge from cutting too deeply into the nail. Thus, the cutting edge  20  cuts into the nail bed and may cut to, but preferably not through, the underlying flesh. If the flesh is contacted, the contact is slight and does not cause bleeding. Thus, the present method is a bloodless procedure. Due to the porous nature of the nail bed, the notch may be sufficiently deep for applying medication for treating fungus without contacting the underlying flesh. This is particularly the case where the flesh is not infected. 
     Although a smooth flat bottom surface  12  is disclosed, any surface which provides depth stopping surface along at least one side of the length of the cutting edge  20  may be employed. For example, the bottom surface may comprise ribs (not shown) parallel to the cutting edge  20  to control cutting depth. 
     If the initially employed nail notcher does not cut a notch sufficiently deep to penetrate the hard outer surface of the nail, then a nail notcher having a cutting edge to provide a deeper cut than the already used nail notcher would be employed. 
     After cutting the appropriate notch or notches, a topical anti-fungal medication would be applied through the notch or notches. The medication could be any of the FDA (Food and Drug Administration) approved anti-fungal medications already in use. The topical medication would be placed into the notch (or notches) and then diffuse through the nail bed into the infected area under the nail. Typical anti-fungal medications which may be employed with the nail notcher  10  of the present invention include chlortrimizol, tolnaftate and undecylenate acid. In addition to the active ingredient, pharmaceutically acceptable adjuvants, stabilizers, preservatives, whiteners, buffers and surfactants may be used in the formulations employed with the present invention. The antifungal composition may be in the form of liquid, gel, semi-solid, cream or solid. It also may be applied as one form, e.g., liquid, which then converts, e.g., dries, to a another form, e.g., solid. 
     Thus, the present invention penetrates the nail plate to expose the nail bed, by an exact depth notch limited by the depth of the cutting edge and the smooth shoulders on either side of the sharp or abrasive edge to facilitate treatment. 
     For example, as shown in FIG. 8, notches  132 ,  134 ,  136  are cut with nail notcher  10  into a toenail  128 . FIG. 8 shows fungus infecting a distal region  130 , relative to the cuticle  138 , of the toenail  128 . Notch  132  is cut into the infected region  130 . Notches  134 ,  136  are cut into an uninfected region  140  of the nail  128  which is proximal to the cuticle  138 . In severe cases all the notches may be cut into an infected portion of nail because little or no uninfected portion is accessible. In some instances the toenail  128  may be filed to smooth its surface prior to cutting the notches into the surface. 
     After the notches are cut, at least one medicine which is a fungicide (kills fungus) or a fungistat (prevents fungus growth) is applied to the notches  132 ,  134 ,  136 . The notches  132 ,  134 ,  136  are cut sufficiently deep to cut into the bed of the nail  128 . Thus, the medication passes into the notches  132 ,  134 ,  136  and through the nail bed. This creates a sterile antiseptic area under the treated portions of the nail, especially for the proximal region  140 . As noted above, the medicine may not kill fungus. However, it at least prevents its growth. Thus, the treatment prevents the fungus in the infected portion  130  from spreading to the uninfected portion  140 . Then antifungal medicine is routinely reapplied to the notches for a sufficient number of days or weeks. During this treatment time, the nail continues to grow and the infected portion  130  grows distally away from the cuticle  138  and is eventually trimmed off to remove the infection from the patient. 
     The present invention is a major advance in treating nail, especially toenail, fungus because it provides for an easy to make, and not too deep, notch into the nail bed. This makes it easy and relatively painless for patients to treat themselves or be treated by a physician or nurse. Also, to apply the topical antifungal medication directly to the nail bed is a major advance. This will make the topical antifungal medications already on the market more effective because they will now directly, contact the nail bed and permeate into the nail bed. 
     It should be apparent that embodiments other than those specifically described above come within the spirit and scope of the present invention. Thus, the present invention is not limited by the above-described embodiments, but rather by the claims appended hereto.