Epidemiology and clinical classification of onychomycosis

Effendy, Isaak; Lecha, M; Chauvin, M. Feuilhade de; Chiacchio, Nilton Di; Baran, Robert

doi:10.1111/j.1468-3083.2005.01281.x

Cited by 136 publications

(94 citation statements)

References 13 publications

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“…Predisposing factors include increasing age, immunosuppression, poor peripheral circulation, diabetes mellitus, nail trauma, tinea manuum, and tinea pedis (11,24,26,29). Dermatophytes are the major cause of nail infection, with the most frequently detected dermatophyte species being Trichophyton rubrum (91%) and Trichophyton mentagrophytes (7.7%) (7,9,28). The treatment of onychomycosis has improved considerably following the introduction of the oral antifungals terbinafine and itraconazole (21).…”

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confidence: 99%

Evaluation of the Morphological Effects of TDT 067 (Terbinafine in Transfersome) and Conventional Terbinafine on Dermatophyte Hyphae In Vitro and In Vivo

Ghannoum

Isham

Henry

et al. 2012

Antimicrob Agents Chemother

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TDT 067 is a novel, carrier-based dosage form of terbinafine in Transfersome (1.5%) formulated for topical delivery of terbinafine to the nail, nail bed, and surrounding tissue. We examined the effects of TDT 067 and conventional terbinafine on the morphology of dermatophytes. Trichophyton rubrum hyphae were exposed to TDT 067 or terbinafine (15 mg/ml) and examined under white light, scanning electron microscopy (SEM), and transmission electron microscopy (TEM). Subungual debris from patients treated with TDT 067 in a clinical trial was also examined. Exposure of T. rubrum hyphae to TDT 067 led to rapid and extensive ultrastructural changes. Hyphal distortion was evident as early as 4 h after exposure to TDT 067. After 24 h, there was complete disruption of hyphal structure with few intact hyphae remaining. Exposure to terbinafine resulted in morphological alterations similar to those seen with TDT 067; however, the effects of TDT 067 were more extensive, whereas a portion of hyphae remained intact after 24 h of exposure to terbinafine. Lipid droplets were observed under TEM following 30 min of exposure to TDT 067, which after 24 h had filled the intracellular space. These effects were confirmed in vivo in subungual debris from patients with onychomycosis who received topical treatment with TDT 067. The Transfersome in TDT 067 may potentiate the action of terbinafine by delivering terbinafine more effectively to its site of action inside the fungus. Our in vivo data confirm that TDT 067 can enter fungus in the nail bed of patients with onychomycosis and exert its antifungal effects.

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mentioning

confidence: 99%

Evaluation of the Morphological Effects of TDT 067 (Terbinafine in Transfersome) and Conventional Terbinafine on Dermatophyte Hyphae In Vitro and In Vivo

Ghannoum

Isham

Henry

et al. 2012

Antimicrob Agents Chemother

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“…Topically, the most widely used drugs are amorolfi ne and ciclopirox olamine, recommended for the treatment of patients with minor problems and those with contraindications to systemic therapy. These drugs usually require longer treatment periods and more discipline [ 24 ]. For patients with restricted access to systemic treatments, a new laser treatment may be an alternative, which has provided good results, but still needs further studies [ 25 ].…”

Section: Infections and Infestationsmentioning

confidence: 99%

Changes in Nails Caused by Aging

Arruda

Talarico

Santos

et al. 2014

Skin, Mucosa and Menopause

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“…Indeed, a positive PCR result indicating the presence of a dermatophyte in the nail provides the physician with sufficient evidence to start antifungal treatment. Species-level identification would require repeating the test on replicate wells with several specific probes, the cost of which might not be justified when T. rubrum accounts for most dermatophytic nail infections in Europe (4,21).…”

Section: Discussionmentioning

confidence: 99%

Multicenter Evaluation of a Commercial PCR-Enzyme-Linked Immunosorbent Assay Diagnostic Kit (Onychodiag) for Diagnosis of Dermatophytic Onychomycosis

Savin¹,

Huck

Rolland

et al. 2007

J Clin Microbiol

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We prospectively evaluated a new PCR-enzyme-linked immunosorbent assay kit (Onychodiag; BioAdvance, France) for the diagnosis of dermatophytic onychomycosis by testing nail samples from 438 patients with suspected onychomycosis and from 108 healthy controls in three independent laboratories. In two laboratories, samples were collected by trained mycologists as close as possible to the lesions (proximal samples). In one laboratory, samples were collected by other physicians. All samples were processed by conventional mycological techniques and by Onychodiag, blindly to the mycological results. An additional distal sample, collected by clipping the nail plate, was obtained from 75 patients and tested with Onychodiag alone. In patients with culture-proven dermatophytic onychomycosis, the sensitivity of Onychodiag was 83.6% (87.9% including the gray zone) and ranged from 75 to 100% according to the laboratory and the sampling conditions. The specificity was 100% when healthy subjects were considered true negative controls. Onychodiag was positive on 68 patient samples that were sterile or yielded nondermatophyte species in culture. Based on the results of Onychodiag for mycologically proven positive samples and true-negative samples, these results were considered true positives, and the poor performance of mycology on these samples was attributed to inconvenient sampling conditions or to contaminants. When tested on distal samples, Onychodiag was positive in 49/53 (92%) cases of proven dermatophytic onychomycosis. Finally, with either proximal or distal samples, Onychodiag provided a diagnosis of dermatophytic onychomycosis within 24 to 48 h after sampling, and its sensitivity was close to that of mycological techniques applied to proximal samples.

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Epidemiology and clinical classification of onychomycosis

Cited by 136 publications

References 13 publications

Evaluation of the Morphological Effects of TDT 067 (Terbinafine in Transfersome) and Conventional Terbinafine on Dermatophyte Hyphae In Vitro and In Vivo

Evaluation of the Morphological Effects of TDT 067 (Terbinafine in Transfersome) and Conventional Terbinafine on Dermatophyte Hyphae In Vitro and In Vivo

Changes in Nails Caused by Aging

Multicenter Evaluation of a Commercial PCR-Enzyme-Linked Immunosorbent Assay Diagnostic Kit (Onychodiag) for Diagnosis of Dermatophytic Onychomycosis

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