Epidemiology of onychomycosis in southern Greece

Rigopoulos, Dimitrios; Katsiboulas, V.; Koumantaki, E.; Emmanouil, Penny; Papanicolaou, A; Katsambas, Andreas

doi:10.1046/j.1365-4362.1998.00613.x

Cited by 25 publications

(36 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our own unpublished data, the incidence of onychomycosis in 103 patients with nail psoriasis (Fig. ) has been found to be 11.67% and this number does not differ in a statistically significant manner from the incidence of onychomycosis that was found in Southern Greece published by one of the authors of this study …”

Section: Should We Distinguish the Two Diseases Or Should We Prove Thsupporting

confidence: 50%

Onychomycosis in patients with nail psoriasis: a point to point discussion

Rigopoulos

Papanagiotou

Daniel

et al. 2016

Mycoses

Self Cite

View full text Add to dashboard Cite

Onychomycosis is the most common nail disease and affects large parts of the population. Psoriasis is a frequently encountered skin disorder with nail involvement being found in up to 80% of the patients at some time of the course of the disease. It has been postulated that onychomycosis occurs more frequently in patients with nail psoriasis, but the results of studies in the literature are controversial. Moreover, onychomycosis could exacerbate psoriasis through Koebner phenomenon and the treatment of psoriasis could predispose to onychomycosis. Finally, the differential diagnosis could be a real challenge due to many same clinical signs, the high prevalence and the possible coexistence of the two diseases. This article attempts to enlighten all these different aspects of a very close relationship.

show abstract

Section: Should We Distinguish the Two Diseases Or Should We Prove Thsupporting

confidence: 50%

Onychomycosis in patients with nail psoriasis: a point to point discussion

Rigopoulos

Papanagiotou

Daniel

et al. 2016

Mycoses

Self Cite

View full text Add to dashboard Cite

show abstract

“…The prevalence of these pathogens, however, varies according to geography, climate, and patterns of population migration, and it may differ among regions with similar environmental conditions. The few onychomycosis studies that have been carried out for the Balkan region (27,39,41,48), where the patient population of the present study originated, have shown that the two dermatophyte species predominate, making up 55 to 70% of isolates from nails, while molds and yeasts are less common, growing from 10 to 27% of specimens (but not always rigorously implicated as causal). Variation among countries is evident.…”

Section: Discussionmentioning

confidence: 71%

Forty-Eight-Hour Diagnosis of Onychomycosis with Subtyping ofTrichophyton rubrumStrains

et al. 2006

View full text Add to dashboard Cite

A novel strategy for the molecular identification of fungal agents of onychomycosis (including Trichophyton rubrum) has been designed based on the use of species-specific and universal primers in conjunction with a commercial kit that allows the extraction of DNA directly from the nail specimens. The microsatellite marker T1, which is based on a (GT)n repeat, was applied for the species-specific identification of Trichophyton rubrum. To evaluate how often Scopulariopsis spp. are detected in nail specimens, a second primer pair was designed to amplify specifically a 336-bp DNA fragment of the 28S region of the nuclear rRNA gene of S. brevicaulis and closely related species. Other fungal species were identified using amplification of the internal transcribed spacer (ITS) region of the rRNA gene, followed by restriction fragment length polymorphism analysis or sequencing. In addition, polyacrylamide gel separation of the T1-PCR product allowed subtyping of T. rubrum strains. We studied 195 nail specimens (the "nail sample") and 66 previously collected etiologic strains (the "strain sample") from 261 onychomycosis patients from Bulgaria and Greece. Of the etiologic agents obtained from both samples, T. rubrum was the most common organism, confirmed to be present in 76% of all cases and serving as the sole or (rarely) mixed etiologic agent in 199 of 218 cases (91%) where the identity of the causal organism(s) was confirmed. Other agents seen included molds (6% of cases with identified etiologic agents; mainly S. brevicaulis) and other dermatophyte species (4%; most frequently Trichophyton interdigitale). Simultaneous infections with two fungal species were confirmed in a small percentage of cases (below 1%). The proportion of morphologically identified cultures revealed by molecular study to have been misidentified was 6%. Subtyping revealed that all but five T. rubrum isolates were of the common type B that is prevalent in Europe. In comparison to microscopy and culture, the molecular approach was superior. The PCR was more sensitive (84%) than culture (22%) in the nail sample and was more frequently correct in specifically identifying etiologic agents (100%) than microscopy plus routine culture in either the nail or the strain samples (correct culture identifications in 96% and 94% of cases, respectively). Using the molecular approach, the time for diagnosing the identity of fungi causing onychomycosis could be reduced to 48 h, whereas culture techniques generally require 2 to 4 weeks. The early detection and identification of the infecting species in nails will facilitate prompt and appropriate treatment and may be an aid for the development of new antifungal agents.

show abstract

“…Secondly, because of limitations in our laboratory facilities, the diagnosis of onychomycosis was limited to histopathologic examination (KOH stain) of the toenails, with no fungus culture. Although Rigopoulos et al 32 . reported that toenail onychomycosis was caused most frequently by dermatophytes (71%), a previous study in Taiwan reported that 60.5% of onychomycosis was caused by dermatophytes, 31.5% by Candida , and 8% by nondermatophyte molds 33 .…”

Section: Discussionmentioning

confidence: 93%