Clinicomycological and histopathological profile of onychomycosis: A cross-sectional study from South India

Chetana, Kayathi; Menon, Roshni; David, Brinda G; Ramya, M R

doi:10.4103/ijd.ijd_160_18

Cited by 6 publications

(10 citation statements)

References 16 publications

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“…A summary of NDM prevalence reported across studies stratified by the geographical location, as well as by the sampling method used (all studies vs. repeated sampling), is shown in Table 1 4–77 . Although the adoption of repeated sampling can increase the diagnostic confidence in a case of NDM onychomycosis, ruling out isolation of the facultatively pathogenic agent as a random contaminant, we did not find significant differences in the predominant NDM strain detected from studies with repeated and unrepeated sampling procedures except in North America 7–13 …”

Section: Epidemiology Of Ndm Onychomycosismentioning

confidence: 77%

A comprehensive review of nondermatophyte mould onychomycosis: Epidemiology, diagnosis and management

Gupta,

Wang,

Cooper

et al. 2023

Acad Dermatol Venereol

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Nondermatophyte moulds (NDMs) are widely distributed and can be detected in association with mycotic nails; however, sometimes it can be challenging to establish the role of NDMs in the pathogenesis of onychomycosis (i.e. causative vs. contaminant). In studies where the ongoing invasive presence of NDMs is confirmed through repeat cultures, the global prevalence of NDMs in onychomycosis patients is estimated at 6.9% with the 3 most common genus being: Aspergillus, Scopulariopsis and Fusarium. NDM onychomycosis can, in many cases, appear clinically indistinguishable from dermatophyte onychomycosis. Clinical features suggestive of NDMs include proximal subungual onychomycosis with paronychia associated with Aspergillus spp., Fusarium spp. and Scopulariopsis brevicaulis, as well as superficial white onychomycosis in a deep and diffused pattern associated with Aspergillus and Fusarium. Longitudinal streaks seen in patients with distal and lateral onychomycosis may serve as an additional indicator. For diagnosis, light microscopic examination should demonstrate fungal filaments consistent with an NDM with at least two independent isolations in the absence of a dermatophyte; the advent of molecular testing combined with histological assessment may serve as an alternative with improved sensitivity and turnover time. In most instances, antifungal susceptibility testing has limited value. Information on effective treatments for NDM onychomycosis is relatively scarce, unlike the situation in the study of dermatophyte onychomycosis. Terbinafine and itraconazole therapy (continuous and pulsed) appear effective to varying extents for treating onychomycosis caused by Aspergillus, Fusarium or Scopulariopsis. There is scant literature on oral treatments for Neoscytalidium.

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Section: Epidemiology Of Ndm Onychomycosismentioning

confidence: 77%

A comprehensive review of nondermatophyte mould onychomycosis: Epidemiology, diagnosis and management

Gupta,

Wang,

Cooper

et al. 2023

Acad Dermatol Venereol

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“…Autoimmune diseases, cancer or immunodeficiency disorders, nephrotic syndrome, hypo‐hyperthyroidism, pyelonephritis, bronchiectasis, and rheumatoid arthritis are among the diseases reported in a few cases in the literature. The nail has been observed to heal after treatment when there is a paraneoplastic syndrome due to underlying malignancy 27 …”

Section: Discussionmentioning

confidence: 99%

“…The nail has been observed to heal after treatment when there is a paraneoplastic syndrome due to underlying malignancy. 27 Mycological agent was detected in only half of all onychopathies clinically suspected to be onychomycosis. 28 The fungus could not be isolated in the culture in 5% of the patients, and clinical presentation was reported to be caused by traumatic onycholysis in another study.…”

Section: Discussionmentioning

confidence: 99%

The change of causative pathogens in toenail onychomycosis

Kara

2020

J of Cosmetic Dermatology

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Some skin diseases such as psoriasis and lichen planus, systemic diseases, circulatory disorders, malignancies, trauma, fungal pathogenic agents, or idiopathic causes are among the causes of color change and deformity in the nails. The most common infection of the nail is due to fungal agents. Onychomycosis (OM) is a fungal infection of the nail plate caused by dermatophytes, nondermatophyte molds (NDM), and yeasts. The incidence of onychomycosis is 5% worldwide. It is 4-20 times more common in toenails than in fingernails. 1 It has been reported that immunosuppressed patients, patients with diabetes mellitus, and patients

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“…OM is the most common nail disorder, and it accounts for more than half of all onychopathies and 30% of fungal skin infections [ 1 , 2 ]. OM prevalence varies between 0.5 and 14 % in different parts of the world [ 1 , 2 , 5 ]. OM results in discoloration, thickening, and separation from the nail bed.…”

Section: Introductionmentioning

confidence: 99%

“…Onychomycosis (OM) is defined as the persistent fungal infection of the nail and nail bed brought on by dermatophytes, non-dermatophyte molds, and yeasts [1][2][3][4][5][6]. OM is the most common nail disorder, and it accounts for more than half of all onychopathies and 30% of fungal skin infections [1,2]. OM prevalence varies between 0.5 and 14 % in different parts of the world [1,2,5].…”

Section: Introductionmentioning

confidence: 99%

Retrospective Analysis of Liver Enzyme Abnormalities in Patients Prescribed Terbinafine and Itraconazole for Onychomycosis

Etgü

2023

Cureus

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Introduction Onychomycosis (OM) is defined as a nail fungal infection. Its prevalence increases with advancing age. Human-to-human transmission makes it a serious public health risk. Although OM is not a life-threatening disease, it has a detrimental effect on patients’ quality of life. Due to the long therapy duration and potential side effects of systemic antifungal medicines, physicians may be reluctant to treat OM orally. In this study, we aimed to evaluate the effect of terbinafine and itraconazole on liver transaminases, the side effects of these treatments, and patients' adherence to systemic treatment of OM. Methods This is a retrospective study conducted in our dermatology department (Ordu University, Ordu) between June 2020 and October 2021. Hospital records were analyzed, and patients with the diagnosis of tinea unguium (ICD code B35.1) were investigated. Patients who were prescribed terbinafine or itraconazole were included in the study. Following a clinical diagnosis of OM, the researchers first tried to confirm it through direct microscopic examination with potassium hydroxide (KOH). If the direct microscopic examination was negative but the suspicion about OM continued, confirmation was done through a fungal culture. Results This study included 735 patients, of whom 409 (55.6%) were female and 326 (44.4%) were male. The research covered all of the patients who were given one of these two medications. To find patients who could apply to other hospitals, the Turkish National Healthcare System was checked in addition to hospital information. To identify patients who could apply to other healthcare institutions, all hospitals share their data with this national healthcare system. Terbinafine was used by 433 patients (76.4%), 75 patients (13.2%), and 37 patients (6.5%), respectively, for one, two, and three months. A total of 119 patients (70.8%) took itraconazole for a month, 32 patients (19%) took it for two months, and four patients (2.33%) took it for three months. At the end of the first month, the proportion of the patients with elevated aspartate transaminase (AST) levels was 5.2% for terbinafine and 0% for itraconazole. Eighteen (8.4%) patients with terbinafine had elevated alanine aminotransferase (ALT) levels, and four patients (7.5%) who were on itraconazole treatment had high ALT levels. None of the patients reported cutaneous adverse drug reactions, gastrointestinal disturbances, or headaches due to OM treatment. Also, no patients discontinued treatment because of hepatotoxicity. Conclusion In this study, none of the patients discontinued the treatment because of hepatotoxicity. According to the results of this study, oral terbinafine and itraconazole can be used with close follow-up. Baseline and regular laboratory monitoring for AST and ALT should be done to monitor liver toxicity with terbinafine and itraconazole. Besides, we did not observe other side effects like cutaneous or cardiac side effects or drug...

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Clinicomycological and histopathological profile of onychomycosis: A cross-sectional study from South India

Cited by 6 publications

References 16 publications

A comprehensive review of nondermatophyte mould onychomycosis: Epidemiology, diagnosis and management

A comprehensive review of nondermatophyte mould onychomycosis: Epidemiology, diagnosis and management

The change of causative pathogens in toenail onychomycosis

Retrospective Analysis of Liver Enzyme Abnormalities in Patients Prescribed Terbinafine and Itraconazole for Onychomycosis

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