Onychomycosis is no longer a rare finding in children

BackgroundAlthough tinea unguium in children has been studied in the past, no specific etiological agents of onychomycosis in children has been reported in Korea.ObjectiveThe purpose of this study was to investigate onychomycosis in Korean children.MethodsWe reviewed fifty nine patients with onychomycosis in children (0~18 years of age) who presented during the ten-year period between 1999 and 2009. Etiological agents were identified by cultures on Sabouraud's dextrose agar with and without cycloheximide. An isolated colony of yeasts was considered as pathogens if the same fungal element was identified at initial direct microscopy and in specimen-yielding cultures at a follow-up visit.ResultsOnychomycosis in children represented 2.3% of all onychomycosis. Of the 59 pediatric patients with onychomycosis, 66.1% had toenail onychomycosis with the rest (33.9%) having fingernail onychomycosis. The male-to-female ratio was 1.95:1. Fourteen (23.7%) children had concomitant tinea pedis infection, and tinea pedis or onychomycosis was also found in eight of the parents (13.6%). Distal and lateral subungual onychomycosis was the most common (62.7%) clinical type. In toenails, Trichophyton rubrum was the most common etiological agent (51.3%), followed by Candida albicans (10.2%), C. parapsilosis (5.1%), C. tropicalis (2.6%), and C. guilliermondii (2.6%). In fingernails, C. albicans was the most common isolated pathogen (50.0%), followed by T. rubrum (10.0%), C. parapsilosis (10.0%), and C. glabrata (5.0%).ConclusionBecause of the increase in pediatric onychomycosis, we suggest the need for a careful mycological examination of children who are diagnosed with onychomycosis.

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“…Recently, however, 16~18 age group were also included in the subject of pediatric onychomycosis5-8,15,21.…”

Section: Discussionmentioning

confidence: 99%

Onychomycosis in Children: An Experience of 59 Cases

Kim

Suh

2013

Ann Dermatol

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“…In the proximal subungual type of onychomycosis with paronychia, nail lesions are almost always caused by Candida species, mainly C. albicans, but other Candida species such as C. parapsilosis and C. tropicalis may also be implicated. Although most of the researchers have introduced dermatophytes as the most important causative agents of onychomycosis 4,7,[19][20][21] , studies carried out by other investigators have demonstrated a greater prevalence of candidas 17,21,39) . Yeast onychomycosis accounts for nearly half of all nail disorders 31) and 46.…”

Section: Discussionmentioning

confidence: 99%

Onychomycosis in Iran: Epidemiology, Causative Agents and Clinical Features

Aghamirian

Ghiasian

2010

Nippon Ishinkin Gakkai Zasshi

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Background: Onychomycosis represents the most frequently encountered nail disease, which is difficult to eradicate with drug treatment. Aim: This study was undertaken to document the clinicomycological pattern of onychomycosis in Iran. Results of mycological tests of nail scrapings collected over a 4-year period were analyzed. Methods: Both direct microscopy and cultures of the nail material were performed to identify the causative agents. Results: The microscopic and/or cultural detection of fungi was positive in 40.2% of samples. The most common clinical type noted was distolateral subungual onychomycosis in 48.4% of cases. Etiological fungal agents were 50% dermatophytes, 46.8% yeasts, and 3.2% saprophytic moulds. The most frequently detected dermatophyte species were Trichophyton rubrum(48.4%)and T. mentagrophytes(41.9%) . Among yeasts, Candida albicans(58.6)was most common, followed by C. parapsilosis(17.2%) , C. glabrata(10.3%) , C. krusei and C. tropicalis(each 6.9%) . Aspergillus niger and A. flavus were the most frequent saprophytic moulds. Females were affected more frequently than males, and in both sexes those most infected were between 40-49 years of age. Fingernails were affected more frequently than toenails. Conclusions: The clinico-epidemiological data collected can serve as reference for future research and may be useful in the development of preventive and educational strategies.

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“…Infrequent consultations by adolescents, pediatricians' lack of knowledge, or insufficient systemic examination of the nails are the possible factors leading to misdiagnosis. [3].…”

Section: Discussionmentioning

confidence: 95%