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Ogawa T, Matsuda A, Ogawa Y, Tanaka R. Risk factors for the development of tinea pedis and onychomycosis: Real-world evidence from a single-podiatry center, large-scale database in Japan. J Dermatol 2024; 51:30-39. [PMID: 37904622 DOI: 10.1111/1346-8138.16991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 09/12/2023] [Accepted: 09/23/2023] [Indexed: 11/01/2023]
Abstract
Dermatomycosis, including tinea pedis and onychomycosis, is frequently encountered in routine medical care in Japan. Identifying the risk factors for tinea pedis and onychomycosis development is important to encourage hospital visits by patients who may have these diseases but who are not undergoing any treatment. This approach may lead to the prevention of disease progression and the spread of infections to others. Risk factors for onychomycosis development have been reported both in and outside of Japan. However, most of the risk factors were identified based on a multicenter, questionnaire survey study and included evidence obtained from unclear or inconsistent diagnostic criteria for tinea pedis, onychomycosis, and identified risk factors. The current study analyzed the risk factors for developing tinea pedis and onychomycosis in real-world practice in Japan using a single-center, large-scale database that included the data of patients managed with consistent diagnostic criteria at the Podiatry Center of Juntendo University Hospital. A total of 2476 patients (1012 males, 1464 females) with a mean age of 63.4 years were included. Among these patients, 337 (13.6%) had tinea pedis and 346 (14.0%) had onychomycosis. A total of 259 patients (~ 75% of each patient population) had both diseases concomitantly. Multivariate logistic regression analysis adjusted for the possible risk factors of age (per 10 years), sex, diabetes, dialysis, visual impairment, ulcer history, lower-limb ischemia (LLI), and diabetic peripheral neuropathy (DPN) revealed that advanced age, male sex, diabetes, and LLI were independent risk factors for the development of tinea pedis. In addition, DPN was an independent risk factor for developing onychomycosis. We believe that these data are useful for identifying patients who are at high risk of developing tinea pedis and onychomycosis, which may result in disease prevention and suppression in real-world clinical practice in Japan.
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Affiliation(s)
- Takasuke Ogawa
- Department of Dermatology and Allergology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Podiatry Center, Juntendo University Hospital, Tokyo, Japan
| | - Akinori Matsuda
- Department of Dermatology and Allergology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yumi Ogawa
- Department of Dermatology and Allergology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Rica Tanaka
- Podiatry Center, Juntendo University Hospital, Tokyo, Japan
- Division of Regenerative Therapy, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Plastic and Reconstructive Surgery, Juntendo University School of Medicine, Tokyo, Japan
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Valentín-Martín A, Hernández-Pérez N, Romero-Noreña A, Molina-Moreno JM. Onychomycosis of rare etiology. Enferm Infecc Microbiol Clin (Engl Ed) 2022; 40:330-331. [PMID: 35469819 DOI: 10.1016/j.eimce.2022.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/14/2021] [Accepted: 07/26/2021] [Indexed: 06/14/2023]
Affiliation(s)
| | | | - Alicia Romero-Noreña
- Centro de Salud de Onda, Departamento de Salud Villarreal, Onda, Castellón, Spain
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Abstract
The relation between tinea pedis and the internal environment of footwear has not been scientifically proven. This study aimed to determine whether the internal environment of footwear affects the incidence of tinea pedis and tinea unguium. This cross-sectional, observatory study involved 420 outpatients who were categorized into non-tinea, tinea pedis or tinea unguium groups based on mycological analysis. External climatic conditions, and temperature, humidity and dew points inside the patients' footwear were recorded. Univariate and multivariate analyses were used to determine independent risk factors for tinea pedis and tinea unguium. A significant correlation was found between high temperature/high humidity and dew point of the internal environment of the footwear and the season. Furthermore, those who wore footwear with internal environments characterized by high temperature, high humidity, high-temperature/high-humidity and high dew point values had a significantly higher incidence of tinea pedis. The internal dew point correlated with the incidence of tinea pedis, whereas the external temperature correlated with the incidence of tinea unguium. The internal humidity and dew point of footwear as well as the frequency with which footwear with a high-temperature/high-humidity internal environment were worn was significantly higher in men than in women. In conclusion, the internal environment of footwear is a risk factor for tinea pedis, and this environment is affected by the season. Moreover, the frequency of tinea pedis among men is related to the internal environment of footwear. The dew point is an appropriate index for evaluating temperature and humidity in relation to tinea pedis.
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Andersen PL, Henning MAS, Jemec GBE, Arendrup MC, Saunte DM. Two Cases of Proximal Subungual Onychomycosis Caused by Trichophyton rubrum in HIV-negative Patients During Treatment with TNF-α Inhibitors Combined with Methotrexate. Acta Dermatovenerol Croat 2018; 26:304-306. [PMID: 30665479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Proximal subungual onychomycosis (PSO) is a rare subtype of onychomycosis with a clinical presentation characterized by proximal leukonychia in the lunular area of the nail. PSO is associated with immunosuppression and regarded a sign of Human Immunodeficiency Virus (HIV) infection when caused by Trichophyton (T.) rubrum. We present two cases of PSO caused by T. rubrum developed during treatment with TNF-α inhibitors combined with methotrexate (MTX).
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Affiliation(s)
| | | | | | | | - Ditte Marie Saunte
- Assist. Prof. Ditte Marie L. Saunte, MD, PhD, Department of Dermatology Zealand University Hospital; Roskilde, Sygehusvej 5, DK-4000 Roskilde, Denmark;
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Sultana S, Jaigirdar QH, Islam MA, Azad AK. Frequency of Fungal Species of Onychomycosis between Diabetic and Non-Diabetic Patients. Mymensingh Med J 2018; 27:752-756. [PMID: 30487490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Onychomycosis is a common nail problem in our country. Diabetic patients are more prone to develop onychomycosis. Various types of fungi are the causative agents of nail infections. This cross sectional explorative study was designed to find out the pattern of onychomycosis among diabetic and non-diabetic patients attending the out patient Department of Dermatology and Venereology and Endocrinology of Bangabandhu Sheikh Mujib Medical University Hospital, Dhaka, Bangladesh from July 2012 to June 2013. Clinically diagnosed patients of onychomycosis with diabetic or non-diabetic were included purposively in this study. Scraping or clipping from infected nail materials were processed for microscopy and culture in Sabouraud's dextrose agar media and Dermatophyte test media. Clinical features, microscopic examination results and culture interpretations were recorded and compared in two groups. A total of 87 clinically diagnosed patients of onychomycosis were included in this study. Out of 87 patients of onychomycosis, 54 patients were diabetic and 33 patients were non-diabetic. Trichophyton rubrum and Trichophyton mentagrophytes were found in 24(44.44%) and 19(35.18%) diabetic patients. Candida albicans and non-albicanscandida species were found in 1(1.85%) and 2(3.70%) diabetic patients. On the other hand, Trichophyton rubrum and Trichophyton mentagrophytes were found in 1(3.03%) and 2(6.06%) non-diabetic patients. Candida albicans and non-albicanscandida species were found in 8(24.24%) and 8(24.24%) non-diabetic patients. Growth of fungus was found in 46(85.19%) diabetic patients which was significant (p=0.004) compared to that found in 19(57.58%) non-diabetic patients. No growth was found in 8(14.81%) diabetic and in 14(42.42%) non-diabetic patients. Dermatophytes were more found in diabetic patients and Candida albicans and non-albican Candida spp. were more found in non-diabetic patients. So, the pattern of onychomycosis was different in diabetics compared to non-diabetics. Further study may be done with large number of sample to determine more accurate pattern of onychomycosis among diabetics.
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Affiliation(s)
- S Sultana
- Dr Sharmin Sultana, Medical Officer, Department of Dermatology & Venereology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
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Chiu HH, Lan CCE, Wu CS, Kuo KC, Chen GS, Wei KC. Onychomadesis following hand-foot-and-mouth disease. Cutis 2016; 97:E20-E21. [PMID: 27274554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Hsiu-Hui Chiu
- Department of Dermatology, Pingtung Christian Hospital; Department of Dermatology, Kaohsiung Municipal Ta-Tung Hospital; Department of Dermatology, Kaohsiung Medical University Hospital, Taiwan
| | - Cheng-Che E Lan
- Department of Dermatology, Kaohsiung Medical University Hospital; Department of Dermatology, Kaohsiung Municipal Ta-Tung Hospital; Department of Dermatology, College of Medicine, Kaohsiung Medical University, Taiwan
| | - Chieh-Shan Wu
- Department of Dermatology, Kaohsiung Medical University Hospital; Department of Dermatology, Kaohsiung Veterans General Hospital, Taiwan
| | - Kuang-Che Kuo
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taiwan
| | - Gwo-Shing Chen
- Department of Dermatology, Kaohsiung Medical University Hospital; Department of Dermatology, College of Medicine, Kaohsiung Medical University, Taiwan
| | - Kai-Che Wei
- Department of Dermatology, Kaohsiung Veterans General Hospital, Taiwan
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Imbert JL, G Gomez JV, Escudero RB, Blasco JL. [Onychomycosis by yeast not common in diabetics of a health center]. Semergen 2015; 42:449-457. [PMID: 26482238 DOI: 10.1016/j.semerg.2015.08.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 06/08/2015] [Accepted: 08/14/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND Mexican diabetic population frequently presents mycosis under foot hyperkeratosis; however, in another type of onychomycosis as the ones that is assumed Candida albicans is the causal agent, it is unknown the frequency, the prevalence and if another Candida species or other yeasts are found. OBJECTIVE Evaluate the frequency of yeasts causing onychomycosis in diabetic patients looked after in public institutions of health of the State of Hidalgo, Mexico, and its association with clinical epidemiological variables. MATERIALS AND METHODS An observational, descriptive and transversal study was made on 261 patients, from which one nail sample of each one was obtained, used to isolate and identify dermatophytes and yeasts; the results were statistically correlated with 24 epidemiological parameters. The clinical study was done through interrogation and by medical exploration in order to evaluate Tinea pedis and onychomycosis. RESULTS Onychomycosis were caused by Candida guilliermondii, Candida parapsilosis, Candida glabrata, Candida krusei, Candida spp., Kodamaea ohmeri, Prototheca wickerhamii and unidentified yeasts. The prevalence for general onychomycosis, by dermatophytes, mixed onychomycosis and by yeasts were: 24.1, 19.5, 2.3 and 14.6%, respectively. Patients with significant probability to be diagnosed as having onychomycosis by yeasts are those wearing open shoes (2.59%); technicians and professionals (10.49%) and alcohol drinkers (3.72%). CONCLUSION The fact that Candida albicans is not present in this study as causal agent of onychomycosis, and emerging and non-common yeasts were indeed isolated, creates new challenges. It is remarked the clinical criterion that when onychomycosis is suspected in diabetics, the diagnosis for culturing dermatophytes and yeasts should be included.
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Affiliation(s)
- J L Imbert
- Universidad Autónoma del Estado de Hidalgo Pachuca, Pachuca de Soto, Hidalgo, México.
| | - J V G Gomez
- Especialidad de Parasitología, Área Académica de Medicina, Instituto de Ciencias de la Salud, Universidad Autónoma del Estado de Hidalgo, Pachuca de Soto, Hidalgo, México
| | - R B Escudero
- Maestría en Ciencias, Área Académica de Medicina, Instituto de Ciencias de la Salud, Universidad Autónoma del Estado de Hidalgo, Pachuca de Soto, Hidalgo, México
| | - J L Blasco
- Maestría en Biotecnología, Universidad Politécnica de Pachuca, Pachuca de Soto, Hidalgo, México
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Ferrari J. Fungal Toenail Infections. Am Fam Physician 2015; 92:132-133. [PMID: 26176372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Jill Ferrari
- The University of East London, London, United Kingdom
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10
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Méndez-Tovar LJ, Arévalo-López A, Domínguez-Aguilar S, Manzano-Gayosso P, Hernández-Hernández F, López Martínez R, Silva González I. [Onychomycosis frequency in psoriatic patients in a tertiary care hospital]. Rev Med Inst Mex Seguro Soc 2015; 53:374-379. [PMID: 25984624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND The changes in psoriatic nails can closely resemble an onychomycosis. Therefore, the fungal infection may be underdiagnosed. It was investigated the frequency of mycosis in fingernails and toenails in 150 patients with psoriasis in a dermatology department. METHODS The clinical data suggestive of onychomycosis were investigated. Nail scales were obtained and cultured on Sabouraud dextrose agar with and without antibiotic. A direct examination with KOH was also performed. RESULTS Out of 150 patients, 67 (45 %) had healthy nails; 42 (28 %) presented onychomycosis and 41 (27 %) showed nail changes without infection. Fingernail changes were more associated with psoriatic onychopathy (82.5 %), unlike toenail changes that were more frequently caused by fungal infection (26.4 % vs. 9.45 % in psoriasis). Out of 20 positive cultures, 22 fungi were isolated, of which 11 belonged to Candida spp. (50 %). As risk factor to develope an onychomycosis, only the psoriasis evolution time showed a significant difference (p = 0.033). CONCLUSIONS In patients with psoriasis, fingernail disorders are mainly due to the own disease, while toenail disorders changes can be associated with onychomycosis. The main etiological agents were yeasts from the genus Candida. The only factor associated with a higher incidence of onychomycosis in these patients was a long lasting psoriasis.
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Affiliation(s)
- Luis Javier Méndez-Tovar
- Laboratorio de Investigación Médica en Dermatología y Micología, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Distrito Federal, México. ,
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Bankhead S, Jackson J, Brodell R. Annular plaques on the back and flanks. J Fam Pract 2015; 64:47-49. [PMID: 25574507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
An 86-year-old African American woman sought care for an asymptomatic rash on her back and flanks that she'd had for 14 months. Physical examination of her trunk revealed 3 to 6 cm annular/arcuate plaques with central clearing. The lesions also had a delicate trailing scale behind a slightly raised erythematous rim. The combination of a ring-shaped rash on the patient's torso and a foot infection led us to the diagnosis.
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Affiliation(s)
- Sarah Bankhead
- Louisiana State University Health Sciences Center, New Orleans, LA, USA
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Ilkit M, Tanir F, Hazar S, Gümüşay T, Akbab M. Epidemiology of Tinea Pedis and Toenail Tinea Unguium in Worshippers in the Mosques in Adana, Turkey. J Dermatol 2014; 32:698-704. [PMID: 16361711 DOI: 10.1111/j.1346-8138.2005.tb00828.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2004] [Accepted: 03/29/2005] [Indexed: 11/29/2022]
Abstract
The aim of this study was to determine the prevalence of dermatomycosis and the risk factors in those who perform their prayers in the mosques in the city center of Adana Province. The diagnosis of dermatomycosis was made on the basis of direct microscopy and/or culture in addition to clinical findings. Among 461 subjects, 136 (29.5%) had tinea pedis, 23 (5.0%) had tinea unguium, and 21 (4.5%) had both infections simultaneously, with a resulting total of 180 (39.0%) cases of dermatomycosis. The causative agents by frequency were: Trichophyton rubrum (67.0%), T. mentagrophytes var. interdigitale (31.1%), and Candida albicans (1.9%). The prevalence of the foot dermatomycosis was found to be high among those who practiced ablution 3-5 times a day and did not dry their feet immediately, who used rubber shoes, and/or who shared their shoes. Pedal dermatophyte infection seems to be a major problem among the adult Muslim male population regularly attending mosques especially in 5th and 6th decades of life.
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Affiliation(s)
- Macit Ilkit
- Department of Microbiology, Faculty of Medicine, University of Cukurova, Adana,Turkey
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Zaias N, Rebell G, Escovar S. Asymmetric gait nail unit syndrome: the most common worldwide toenail abnormality and onychomycosis. Skinmed 2014; 12:217-223. [PMID: 25335350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Asymmetric gait nail unit syndrome (AGNUS) is the result of asymmetric shoe pressure on the toes and foot caused by ubiquitous uneven flat feet that affect the gait. The pressure produces clinical changes in the toenails, which are identical to all clinical types of dermatophyte and opportunistic onychomycosis, yet they are dermatophytes-free. AGNUS produces additional signs that make it easy to identify. Its coexistence with fungal disease has resulted in reports describing new clinical types of onychomycosis, identifying signs of drug resistance, assessing severity index, and defining complete clinical cure when taking a systemic or topical antifungal, as well as "retronychia." These signs are typically seen in the toenails of patients with AGNUS. AGNUS has a mechanical etiology and can coexist with dermatophytosis, which is a hereditary disease. AGNUS can coexist with any other disease affecting the toenails and results in greater clinical severity than each condition individually. AGNUS is and has been the most common worldwide toenail abnormality in shoe-wearing societies.
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Ayanlowo O, Oladele RO. Onychomycosis: updates and management challenges. A review. Niger Postgrad Med J 2014; 21:185-191. [PMID: 25167597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Onychomycosis is a fungal infection which affects the nail unit. It was previously thought to be just a cosmetic problem, but presently, it is regarded as a major public health issue because of the impact on the quality of life of the patients.A etiologic factors identified in onychomycosis include increasing age,immunosuppression, occupation and genetics. Management of onychomycosisis both pharmacological and non pharmacological. Pretreatment counseling is important in patients with fungal nail infections and this should include probable length of therapy, possible side effects of treatment and the expenses involved.Patients should be educated on proper nail care and the fact that no treatment isI 00% effective. Presently, combination therapy is advocated for the management of onychomycosis. This is a review of the epidemiology, clinical types,investigations and current considerations in the management of onychomycosis.
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Bayerl C, Starostzik C. [Artificial nails: the cavities contain lively budding candida (interview by Christine Starostzik)]. MMW Fortschr Med 2014; 156:7. [PMID: 24908756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Bihan H, Brun S, Matichard E, Guyot A, Aich M, Izri A, Reach G. [Diabetic mycosis intertrigo and onychomycosis]. Rev Prat 2014; 64:381-389. [PMID: 24868617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Patient information. Onychomycosis (nail fungus). Am Fam Physician 2013; 88:online. [PMID: 24364530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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[Visit a swimming pool in Moscow as a risk of skin diseases of fungal etiology]. Gig Sanit 2012;:19-22. [PMID: 23082662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
450 persons visited swimming pools in Moscow out of 900 patients seen by a dermatologist, have been questioned. Skin and toenail mycoses plates (18.7% and 21.8% respectively) were shown to prevail in the overall structure of the skin disease in persons who regularly visited swimming pool for a long time. In the structure of the species composition of fungal pathogens of diseases in such persons Trichophyton rubrum (51%) takes the first place, Candida albcans (25.5%) takes the second place.
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Abeck D. [Is it a "nail fungus"? (interview by Dr. Carola Goring)]. MMW Fortschr Med 2010; 152:12. [PMID: 20608122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Altunay ZT, Ilkit M, Denli Y. [Investigation of tinea pedis and toenail onychomycosis prevalence in patients with psoriasis]. MIKROBIYOL BUL 2009; 43:439-447. [PMID: 19795619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The data about the prevalence of onychomycosis in patients with psoriasis is contradictory. In this study, we investigated the prevalence of onychomycosis and tinea pedis in patients with psoriasis compared to control group. A total of 60 patients with psoriasis (27 male, 33 female; mean age: 40.8 +/- 17.6 years) and 60 subjects without psoriasis (27 male, 33 female; mean age: 42.8 +/- 17.3 years) who were admitted to dermatology outpatient clinics of our hospital were included to the study. Scrapings from both normal and abnormal toenails as well as toewebs were examined using microscopy and fungal culture. Foot dermatomycosis was diagnosed in 6 (5 onychomycosis and 1 tinea pedis) patients with psoriasis (10%) and in 8 (5 onychomycosis and 3 tinea pedis) control subjects (13.3%) (p > 0.05). The only dermatophyte fungi isolated in both patients with psoriasis and control group were Trichophyton rubrum (75%) and Trichophyton interdigitale (25%). Onychomycosis was more predominant in male psoriatic patients (p = 0.01). Both distero-lateral subungual onychomycosis (DLSO) and total dystrophic onychomycosis were detected in patients with psoriasis, however, DLSO, was the only clinical type in the control group. Pitting is the most typical lesions in nails in patients with psoriasis (p = 0.04). The use of common showers play a role in transmission of foot dermatomycosis (p = 0.04). In this study, psoriasis was not found as a risk factor for onychomycosis. However, onychomycosis is a major problem in psoriatic nails, and mycological methods would be useful in differential diagnosis. Since dermatomycosis is still an important public health problem, it may be controlled by education of the patient about proper foot hygiene and avoiding walking barefooted in shower areas.
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Affiliation(s)
- Zeynep Tülay Altunay
- Cukurova Universitesi Tip Fakültesi, Mikrobiyoloji Anabilim Dali, Mikoloji Bilim Dali, Adana
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Neupane S, Pokhrel DB, Pokhrel BM. Onychomycosis: a clinico-epidemiological study. Nepal Med Coll J 2009; 11:92-95. [PMID: 19968146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Onychomycosis is a common nail disorder. Far more than being a simple cosmetic problem, infected nail serves as a chronic reservoir, which can give rise to repeated mycotic infections. The study was undertaken to determine the various clinical patterns of onychomycosis. This prospective cross sectional study was conducted in clinically suspected patients of onychomycosis attending out patients department of dermatology, T.U. Teaching hospital between August 2006 and July 2007. Various data were obtained and clinical patterns were noted. Out of 182 clinically suspected patients of onychomycosis, 52.7% were males with male: female ratio of 1.1:1. Onychomycosis was predominant among the younger patients with slight male preponderance. Fingernails were more frequently involved in females whereas toenails in males. The most common clinical type was distal and lateral subungual onychomycosis. 58.2% had other concomitant fungal infections apart from onychomycosis. Onychomycosis could serve as a good reservoir for recurrent cutaneous superficial fungal infections. Hence, adequate treatment of onychomycosis can prevent from these recurrent cutaneous superficial fungal infections.
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Affiliation(s)
- S Neupane
- Department of Dermatology, Nepalgunj Medical College Teaching Hospital, Banke, Nepal.
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olde Hartman TC, van Rijswijk E. [Onychomycosis]. Praxis (Bern 1994) 2009; 98:213-214. [PMID: 19224490 DOI: 10.1024/1661-8157.98.4.213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Affiliation(s)
- T C olde Hartman
- Abteilung für Frauenmedizin, Radboud-Universität Nijmegen, Medical Centre, Nijmegen, Niederlande.
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Affiliation(s)
- Tim C olde Hartman
- Department of Family Medicine, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, Netherlands.
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Batinac T, Zamolo G, Troselj-Vukić B, Biljan D, Petranović D, Kujundzić M. Maculopapular eruption secondary to itraconazole. Coll Antropol 2008; 32:649-651. [PMID: 18756926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Adverse cutaneous reactions to itraconazole are known to be quite rare. We report a case of maculopapular reaction caused by itraconazole. On the 7th day of itraconazole therapy for hand onychomycosis, in a 39-year-old woman pruritus occurred with a subsequent morbiliform, symmetric, maculopapular eruption on the upper torso, neck, trunk and pressure-bearing areas. Eruption progressed, becoming confluent and spreading to extremities. Due to increasing indications for the administration of itraconazole its increased usage as well as the possibility of allergic reactions should be expected even if these are a rare event.
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Affiliation(s)
- Tanja Batinac
- Department of Dermatovenerology, University Hospital Center Rijeka, Rijeka, Croatia.
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25
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Baran R, Faergemann J, Hay RJ. Superficial white onychomycosis—A syndrome with different fungal causes and paths of infection. J Am Acad Dermatol 2007; 57:879-82. [PMID: 17610995 DOI: 10.1016/j.jaad.2007.05.026] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2006] [Revised: 05/02/2007] [Accepted: 05/11/2007] [Indexed: 10/23/2022]
Abstract
Superficial white onychomycosis (SWO) is a clinical term used to describe onychomycosis in which the invasion of the nail plate occurs from the dorsal surface. However, recent observations indicate that the clinical appearances may vary to include infection in patches or in a striate patter. This report shows that, in some cases, it may be combined with either distal and lateral subungual onychomycosis or proximal white subungual onychomycosis. Invasion of the dorsal nail surface, but originating from the proximal nail fold, is another route of infection in SWO. A new classification of this condition is proposed with 4 main variants. Although based on clinical features, often other factors such as immunosuppression or invading organism (eg, Trichophyton rubrum or Fusarium species) appear to play a role in the development of a particular pattern of infection. This is an observational study carried out by trained and experienced clinicians. The main clinical implication is that in combined forms, or where the infection emerges from beneath the proximal nailfold, systemic rather than topical antifungal therapy is advised.
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Abstract
PURPOSE To provide the practitioner with current information on the most common nail disorders. TARGET AUDIENCE This continuing education activity is intended for physicians and nurses with an interest in wound care and related disorders. OBJECTIVES After reading this article and taking this test, the reader should be able to: 1. Describe the structures that compose the nail apparatus. 2. Identify the most common nail disorders, including etiology and treatment.
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Affiliation(s)
- Afsaneh Alavi
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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27
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Abstract
In patients with onychomycosis (OM) 71.5% of them have been reported with plantar fungal infection. The aim of this study was to study the frequency and distribution of plantar and interdigital affection in diabetic patients and in a control group without diabetes, all of them with OM. Diabetic patients with OM were more frequently diagnosed with plantar (61.2%) than interdigital (46.7%) infection. In the control group similar results were obtained; patients with OM in 76.5% had plantar mycotic infection and 67.1% interdigital involvement.
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Affiliation(s)
- Caroline Chanussot
- Sección de Micología, Hospital General Dr. Manuel Gea González, Calzada de Tlalpan 4800, 14000 México D.F., México
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28
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Abstract
A case of onychomycosis with nail dystrophy due to Microsporum gypseum in a healthy 35-year-old woman is described. The infection had a 2-year history, occurring in the site of a nail trauma sustained in a fall from a horse. Diagnosis was based on mycological examination (direct microscope observation and culture). Clinical and mycological recovery was achieved after local treatment with ciclopiroxolamine nail solution and pulsed systemic terbinafine therapy.
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Tuchinda P, Boonchai W, Prukpaisarn P, Maungprasat C, Suthipinittharm P. Prevalence of onychomycosis in patients with autoimmune diseases. J Med Assoc Thai 2006; 89:1249-52. [PMID: 17048436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
BACKGROUND Onychomycosis is the most common nail disorder in adults. Many studies reported a higher prevalence of onychomycosis among particular patients, such as those with diabetes, poor peripheral circulation or immunosuppression. However, studies of the prevalence of onychomycosis in autoimmune patients who carry many of these predisposing factors have been limited OBJECTIVE Study the prevalence of onychomycosis in autoimmune compared to non-autoimmune female patients. MATERIAL AND METHOD A cross-sectional study of the prevalence of onychomycosis in autoimmune patients and non-autoimmune female patients visiting a dermatology clinic over a period of 18 months. One hundred and sixty-five female autoimmune patients were enrolled. RESULTS The prevalence of onychomycosis in autoimmune patients was 10.2% (95%CI 6.5%, 15.9%) compared to 6.7% (95%CI 3.8%, 11.6%), in non-autoimmune patients (p > 0.05, 2-sided). Of vesiculobullous patients, mainly presenting with pemphigus and who were mostly on immunosuppressive medication, 24% had onychomycosis [p = 0.013; OR 4.39 (95%CI 1.27, 14.89)]. CONCLUSION Exposure to humid microenvironments was an important factor in the occurrence of onychomycosis (p < 0.05, 2-sided). However, the number of patients with each individual disease was too small to conclude a prevalence of onychomycosis in conjunction with these individual cutaneous autoimmune diseases.
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Affiliation(s)
- Papapit Tuchinda
- Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
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30
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Weightman W, Phillips P. Diabetes and the skin - onychomycosis. Aust Fam Physician 2006; 35:499. [PMID: 16820820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Case history - Oliver: Oliver is aged 70 years, has had type 2 diabetes for 18 years, and has been treated with insulin for 4 years. He presents after two episodes of cellulitis of his right lower leg and forefoot, which have cleared on antibiotics. There are no residual skin changes on his leg and forefoot other than some postinflammatory pigmentation.
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Abstract
BACKGROUND Onychomycosis represents the most frequently encountered nail disease, which is difficult to eradicate with drug treatment. Epidemiological studies concerning onychomycosis have been performed in many countries worldwide. Differences in the incidence of onychomycosis have been reported not only for various geographical areas, but also for different regions of the same country. OBJECTIVE This survey was undertaken to determine the epidemiology of onychomycosis in the population of Crete, Greece. METHODS In a prospective study, the fingernails and toenails of all new patients presenting to the outpatient Dermatology Department of the University Hospital of Crete were examined by certified dermatologists. If they appeared abnormal, nail material was obtained for mycologic examination. RESULTS A total of 23,477 patients were examined during the study period (1992-2001). Of them, 19,556 (83.3%) participated in the investigation. Clinical abnormal nails were observed in 2098 (10.7%) patients, 36.7% males and 63.3% females. Mycologically confirmed onychomycosis was detected in 511 (24.3%). Toenail onychomycosis was found in 283 (55.4%) patients, fingernail onychomycosis in 210 (41%), and both toenail and fingernail onychomycosis in 18 (3.6%). In the toenail infections, dermatophytes were most frequently isolated (52%), followed by yeasts (24.7%) and moulds (15.5%); 7.8% of the infections were mixed. In the fingernail infections, yeasts were most often isolated (82.9%), followed by dermatophytes (10%), and moulds (1.9%); 5.2% of the infections were mixed. CONCLUSION Because the pattern of onychomycoses in a country is changing with time, epidemiological studies are necessary for determining the prevalence and the causative agents of the infection.
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Affiliation(s)
- D J Ioannidou
- Department of Dermatology, University Hospital of Heraklion, Heraklion, Crete, Greece
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32
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Abstract
Few studies have examined the prevalence of onychomycosis among diabetic patients. Given the morbidity linked to onychomycosis, and the ever-growing size of the diabetic population, a better recognition of this nail infection is welcome. To revisit the relative prevalence of dermatophyte, yeast and non-dermatophytic mould onychomycoses in diabetic adults in a prospective study using combined histomycology and cultures. Toenail clippings were collected for 3 years in 190 type II diabetic patients (136 men and 54 women) and from an age- and gender-matched group of non-diabetic subjects. All sampled nails showed clinical alterations reminiscent of onychomycosis. Histomycology and cultures were performed on each sample to distinguish onychomycosis from non-infectious onychodystrophy. Compared to non-diabetic subjects with nail alterations, diabetics showed a higher proportion of onychomycosis relative to non-fungal onychodystrophy. Diabetic men suffered more frequently from onychomycosis and onychodystrophy than diabetic women. When considering the nature of the fungal pathogens, dermatophytes predominated largely over yeast and non-dermatophytic moulds, both in diabetic and non-diabetic patients. Diabetic patients, particularly men, are at increased risk of developing onychomycosis. The morbidity linked to this disorder, and its impact on the foot status in diabetic subjects merit to be better appreciated by clinicians.
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Affiliation(s)
- Gérald E Piérard
- Department of Dermatopathology, University Hospital of Liège, Liège, Belgium.
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Negroni R, Tuculet MA. [Clinical cases in medical mycology. Case No. 16]. Rev Iberoam Micol 2005; 22:125-6. [PMID: 16107174 DOI: 10.1016/s1130-1406(05)70023-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Ricardo Negroni
- Unidad de Micología, Hospital de Infecciosas Francisco Javier Muñiz, Uspallata 2272 1282, Buenos Aires, Argentina.
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Simonetti O, Bernardini ML, Arzeni D, Cellini A, Barchiesi F, Offidani A. Epidemiology of onychomycosis and paronychia in the area of ANCONA (ITALY) over a period of 5 years. Mycopathologia 2005; 158:271-4. [PMID: 15645167 DOI: 10.1007/s11046-004-9615-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2004] [Accepted: 05/11/2004] [Indexed: 11/24/2022]
Abstract
We retrospectively evaluated the epidemiology of onychomycosis and/or paronychia in 172 patients attending the Clinic of Dermatology and Venereology over a 5 year period. Although yeast isolates, belonging to the Candida species, represented the most frequent etiologic agents of these infections, an increasing prevalence of fungal infections due to emerging fungal pathogens (EFP) was noted throughout this time period. In particular, EFP as causative agents of these infections increased from 0 to 28.4% from 1998 to 2002.
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Affiliation(s)
- O Simonetti
- Clinica Dermatologica, Ospedale Regionale, Via Conca 71, 60020, Torrette, Ancona, Italy.
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Piérard GE. [Some trouble in the field of onychomycosis]. Rev Med Liege 2005; 60:242-6. [PMID: 15943102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Recently, onychomycoses raised some interest from groups whose business is communication to the public. The combination of commercial interest, dogmatism and disinformation appears to have found there a potentially damaging field of action. This review is an attempt to shed some light on this topic using objective and qualified medical information.
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Affiliation(s)
- G E Piérard
- CHU du Sart Tilman, Service de Dermatopathologie, Liège.
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36
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Warpakowski A. [Harmless foot fungus? Not true! Threat of erysipelas]. MMW Fortschr Med 2005; 147:15. [PMID: 15766019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
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Macura AB, Gasińska T, Pawlik B. [Nail susceptibility to fungal infections in patients with hypothyroidism and hyperthyroidism]. Przegl Lek 2005; 62:218-21. [PMID: 16229238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Onychomycosis is a frequent disorder in adults. The objective of the study was evaluation of finger and toe nails susceptibility to Candida albicans and a dermatophyte Trichophyton mentagrophytes infection in patients with symptomatic hypothyroidism and hyperthyroidism as compared with healthy persons. The materials comprised finger and toe nails from 23 patients with hypothyroidism (in 8 cases postoperative, and in 15 cases caused by Hashimoto type thyroiditis), and from 27 patients with hyperthyroidism (including 17 cases of Graves-Basedow disease, and 10 with nodular goitre). Nails from 22 healthy persons of similar sex and age distribution served as controls. A significantly more frequent and more intensive than in control group toe nail infection with C. albicans was found in the patients with both hypothyroidism and hyperthyroidism. The enhanced toe nail susceptibility to C. albicans infection did not depend on autoimmunological aetiology of both hypothyroidism and hyperthyroidism.
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Affiliation(s)
- Anna B Macura
- Zakład Mykologii Katedry Mikrobiologii, Collegium Medicum, Uniwersytetu Jagiellońskiego w Krakowie.
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38
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Information from your family doctor. Fungal infections of the nails. Am Fam Physician 2004; 70:928. [PMID: 15368734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
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39
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Gupta AK, Lynch LE. Onychomycosis: review of recurrence rates, poor prognostic factors, and strategies to prevent disease recurrence. Cutis 2004; 74:10-5. [PMID: 15287395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Treatment of onychomycosis is associated with substantial disease reappearance rates. Identification of factors associated with therapeutic failure may help develop strategies to prevent recurrence of onychomycosis. Aspects of a patient's health and lifestyle, local factors involving the nail, therapeutic options, and environmental conditions are associated with poor therapeutic response. Strategies to reduce recurrence of disease involve the reduction of both relapse (delayed failure) and reinfection. The topical antifungal agent ciclopirox nail lacquer, may be a consideration for prophylaxis of this chronic disease.
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Affiliation(s)
- Aditya K Gupta
- Division of Dermatology, Department of Medicine, Sunnybrook and Women's College Health Sciences Center (Sunnybrook site), the University of Toronto, Canada
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40
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Abstract
This study was carried out to determine whether slow nail growth is a predisposing factor for onychomycosis or if onychomycosis results in slow nail growth. Forty-nine patients with unilateral onychomycosis of the great toenail were enrolled and classified in two groups according to the size of affected area, i.e. more than half or less than half of the toenail. The growth rates of affected and unaffected great toenails of all patients were measured. Before a normal appearance was reached, the growth rates of affected great toenails, when the affected area occupied more than half of total nail plate, was slower than that of the unaffected great toenails. After a normal appearance was achieved, there were no differences in growth rates between affected and unaffected great toenails. Therefore, this study of patients with unilateral toenail onychomycosis did not support the hypothesis that slow nail growth rate is a predisposing factor for onychomycosis.
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Affiliation(s)
- H-J Yu
- Department of Dermatology, Hanyang University College of Medicine, Hanyang University Guri Hospital, Guri City, Gyunggi-do 471-701, South Korea.
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Abstract
OBJECTIVE To examine possible risk factors related to onychomycosis. BACKGROUND Onychomycosis is a common disease with multifactorial aetiology, but little is known about the risk factors for this disease. PATIENTS AND METHODS Questions related to signs, symptoms and possible risk factors associated with onychomycosis were sent to 3992 persons aged 16 years and older selected randomly from the Icelandic National Registry. Patients with suspected onychomycosis, based on photographs, were offered mycological examination. Data from the questionnaire and the results of mycological examination were used to calculate the odds ratio (OR) for several factors that might be associated with onychomycosis. RESULTS Two thousand four hundred and eighty-six subjects responded to the questionnaire. Prevalence for mycologically determined onychomycosis was 11.1% in the Icelandic population. A history of the following factors more than doubled the risk of onychomycosis: cancer (OR 3.44; 95% CI 1.15-10.35), psoriasis (OR 2.44; 95% CI 1.61-3.72), tinea pedis interdigitalis (OR 3.93; 95% CI 3.11-4.95), the moccasin form of tinea pedis (OR 4.26; 94% CI 3.34-5.45), parents with onychomycosis (OR 2.59; 95% CI 1.89-3.53), children with onychomycosis (OR 3.48; 95% CI 2.05-5.88), spouse with onychomycosis (OR 2.53; 95% CI 1.72-3.72), regular swimming activity (OR 2.57; 95% CI 2.00-3.30) and age 50 years or older (OR 2.74; 95% CI 2.19-3.42). CONCLUSIONS Several risk factors are associated with onychomycosis. Knowledge of these risk factors is important when treating and educating patients with onychomycosis.
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Affiliation(s)
- B Sigurgeirsson
- Department of Dermatology, University of Iceland and Landspitali, University Hospital, Reykjavik, Iceland.
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Bouguerra R, Essaïs O, Sebaï N, Ben Salem L, Amari H, Kammoun MR, Chaker E, Zidi B, Ben Slama C. Prévalence et aspects cliniques des mycoses superficielles chez le diabétique tunisien en milieu hospitalier. Med Mal Infect 2004; 34:201-5. [PMID: 16235595 DOI: 10.1016/j.medmal.2004.03.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVES The prevalence of mycotic infection seems to be higher among diabetic patients than in the non-diabetic population. The aims of this study were to determine the frequency of mycosis and to compare clinical and fungal results. PATIENTS AND METHODS This transversal study included 307 type 1 and 2 diabetic patients admitted between January 1998 and January 2000. A dermatologist examined all patients. The mean age was 44 +/- 17 years and the duration of diabetes 8 +/- 6 years. Patients with suspected lesions underwent mycological examination. RESULTS Clinical signs of presumed fungal infection were found in 61% of patients, but mycosis was confirmed only in 30%. Fungal foot infection accounted 38% of the patients, mostly due to dermatophytes (94%). The commonest localizations of dermatophytes were interdigital (60%) followed by onychomycosis (30%). The main fungal agent was Trichophyton rubrum. The main risk factors for fungal infections were the age of patients (P = 0.0003) and duration of diabetes (P < 0.05). Interdigital foot localization of dermatophytes was correlated to age (P < 0.0001) and to the male gender (P < 0.01). The frequency of dermatophytes in nails was higher in type 2 diabetic patients (P < 0.01). Vulvovaginal candidosis and interdigital dermatophytes were more frequent in obese than in non-obese patients. The accuracy and specificity of direct examination were respectively 85% and 79%. CONCLUSION The high frequency of mycosis in diabetic patients at hospital is demonstrated. The main risk factors were age, male gender and obesity.
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Affiliation(s)
- R Bouguerra
- Service d'endocrinologie-diabétologie, institut national de nutrition, Bab-Saadoun, Tunisie
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Abstract
Onychomycosis is a common nail disease, responsible for up to 50% of diseases of the nail. The distribution of different pathogens is not uniform; it depends on various factors such as climate, geography and migration. However, studies have revealed that two dermatophytes, Trichophyton rubrum and Trichophyton mentagrophytes, account for more than 90% of onychomycoses. Onychomycosis can be divided into four major clinical presentations: distal subungal (the most common form of the disease), proximal subungal (the most common form found in patients with human immunodeficiency virus infection), and superficial and total dystrophic onychomycosis. Onychomycosis is a multifactorial disease. Age has a very important effect on the occurrence of onychomycosis, with a correlation between increasing age and infection. Genetics has also been identified as a factor governing the epidemiology of onychomycosis; T. rubrum infection shows a familial pattern of autosomal dominant inheritance. Disease and lifestyle may also play a role in the epidemiology of fungal nail infections. Studies have shown that diabetes, acquired immunodeficiency syndrome and peripheral arterial disease may be independent predictors of onychomycosis. Because of the multifactorial nature of the epidemiology, accurate diagnosis, pertinent treatment and patient education must be paramount when treating the disease.
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Affiliation(s)
- J Faergemann
- Department of Dermatology, Sahlgrenska University Hospital, S-41345 Gothenburg, Sweden.
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Vásquez C, Martín Mateos MA, Giner MT, Sierra JI, Plaza AM, Díaz P, Jiménez-Feijoo R. Otomastoiditis candidiásica y síndrome de hiper Ig E. Allergol Immunopathol (Madr) 2004; 32:82-5. [PMID: 15087095 DOI: 10.1016/s0301-0546(04)79232-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PATIENT A 5-year-old girl presented with chronic otorrhea, cervical adenopathies and cellulitis of the knee. In addition to these lesions, physical examination revealed eczema on the scalp, neck, perineal and umbilical regions and the persistence of deciduous teeth with adult teeth (double dental arch). Complementary investigations showed the following concentrations: IgE 23969 UI/l, IgD 440 U/L, IgG 23000 mg/L, and IgA 4220 mg/L. Intradermal skin testing to Candida was negative and the results of the remaining immunological studies were normal. Computerized axial tomography revealed bilateral otomastoiditis. Candida albicans was isolated from ear secretion cultures. The definitive diagnosis was hyper IgE syndrome. The patient responded favorably to antibiotic and antifungal therapy and is currently undergoing period outpatient monitoring.
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Affiliation(s)
- C Vásquez
- Sección de Alergia e Inmunología Clínica, Unidad Integrada de Pediatría, Hospital Clinic- Hospital Sant Joan de Déu, Universidad de Barcelona, España
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46
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Chabasse D. [Can we evaluate the frequency of onychomycosis?]. Ann Dermatol Venereol 2003; 130:1222-30. [PMID: 14743108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
Onychomycosis represents one of the most common nail diseases. Difficult to bear by some patients, onychomycosis is one of the most frequent reasons for consulting by lack of uniformity and group-control a mycological centre. However, frequency of onychomycosis is miss appreciable. The studies of prevalence concern the general population (2 to 13 per cent according to the different authors) consulting a medical practitioner or specialist (dermatologist). Recent surveys done a large scale in Europe in adults indicated high prevalence: 20 to 30 per cent, depending on whether the investigator is a general practitioner or a dermatologist. In any case, all the studies concur in the opinion that onychomycosis has been in constant progression over the last twenty years. Rarely observed in children, frequent in adults, onychomycosis principally affects particularly the elderly. In Western Europe and in North America, onychomycosis involves principally the feet--especially in males. By contrast, in Southern Europe, in the Middle and Far East, the prevalence is highest in women's fingernails (often associated with paronychia). Among the factors promoting fungal nail invasion, some are local depending on the patient (trophic troubles and circulatory impairment overlapping of digits, etc.), some are due to general factors such as immunosuppression, diabetes mellitus or psoriasis. There are also behavioural factors (occupation, lifestyle, sports) which favor the meeting with the pathogenic fungus.
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Affiliation(s)
- D Chabasse
- Laboratoire de Parasitologie-Mycologie, CHU, Angers, France
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47
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Baran R. [An iconoclast's view of onychomycosis and their treatment]. Ann Dermatol Venereol 2003; 130:1219-21. [PMID: 14743107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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48
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Schuck R. [Onychomycosis. Systemic or local treatment?]. MMW Fortschr Med 2003; 145:19. [PMID: 12822226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
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Affiliation(s)
- Nóra Erös
- Department of Dermatology, Semmelweis Hospital, Csabai kapu 6, H-3501 Miskolc, Hungary
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50
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Abstract
Nail changes occur frequently in adults, but are relatively rare in children. There are, however, certain nail changes that emerge particularly during childhood. Ingrown nails, onychoschizia, congenital slanted alignment of the large toenail, and psoriasiform nail dystrophies can be frequently observed in toddlers and in schoolchildren the syndrome of an ingrown nail, nail artifacts, periungual warts or fibromas, trachyonychia, and nail mycoses. Connatal nail changes can appear as isolated events or together with other symptoms whereas acquired nail changes are caused by infections, traumatic injuries, or tumors, in conjunction with skin diseases or general illnesses, or even develop spontaneously.
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Affiliation(s)
- I Effendy
- HautklinikStädtische Kliniken Bielefeld.
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