Systematic review of nondermatophyte mold onychomycosis: Diagnosis, clinical types, epidemiology, and treatment

Gupta, Aditya K.; Drummond-Main, Chris; Cooper, Elizabeth A.; Brintnell, William; Piraccini, Bianca Maria; Tosti, Antonella

doi:10.1016/j.jaad.2011.02.038

Cited by 225 publications

(267 citation statements)

References 46 publications

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“…The most common NDM isolates in descending order are Scopulariopsis brevicaulis, Fusarium species, Aspergillus species, Scytalidium dimidiatum, and Acremonium species [54]. Onychomycosis associated with NDM has been associated with a poor prognosis [15].…”

Section: Organismsmentioning

confidence: 99%

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Prognostic Factors in Onychomycosis Treatment

Lipner

Scher

2014

J Infect Dis Ther

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Onychomycosis is a common fungal disease of the nail unit with a prevalence of 10% to 12% in the United States. Despite therapeutic innovations in the last few decades, as many as 20-25% of patients do not achieve a complete cure, and 10-53% are reported to relapse after successful treatment. Some of the factors associated with a poor response to onychomycosis have been well studied. They include patient characteristics and morbidities, nail characteristics, and the infecting organism. Therefore, the goal of therapy is to identify these specific prognostic features for each patient and devise an appropriate treatment plan that will allow for the best chance for cure. Scoring systems may be helpful for grading the severity of onychomycosis and predicting the therapeutic outcome.

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Section: Organismsmentioning

confidence: 99%

“…This may be due to the difficulty in diagnosing NDM infections, as they may be innocuous contaminants of the feet and nails or laboratory contaminants. In addition, since they are a relatively uncommon cause of nail infections, there is a paucity of data on treatment regimens [54].…”

Section: Organismsmentioning

confidence: 99%

Prognostic Factors in Onychomycosis Treatment

Lipner

Scher

2014

J Infect Dis Ther

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“…Most studies utilize at least three criteria 11 , and thus we have chosen to apply the first three criteria in our study. At an isolation rate of 24.4%, Aspergillus sp.…”

mentioning

confidence: 99%

Non-dermatophytic moulds and yeasts as agents of onychomycosis in a Malaysian medical centre

Ding

Rahman

Khaithir

et al. 2017

Bangladesh J Med Sci

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Abstract:Objective: Onychomycosis can be caused by numerous fungi, with geographical and temporal factors influencing the prevalence of the various aetiological agents. We set out to identify and classify the various fungi cultured from the nail clippings of patients diagnosed with onychomycosis in UKM Medical Centre, Malaysia. Methods: This retrospective study involved cases of onychomycosis diagnosed from January 2013 to July 2014. For each fungus, mycological diagnosis was achieved by direct microscopic examination of the nail clipping(s) followed by morphological identification of the fungus following culture on various artificial media. Results: A total of 180 fungal isolates were cultured from the nail clippings of 146 different patients. Non-dermatophytic moulds accounted for most of the fungal isolates (59.8%), followed by yeasts (35.7%) and dermatophytes (4.5%). Overall, Candida was the most frequently isolated fungal genus and Aspergillus was the most frequently cultured mould genus. Out of the three dermatophyte genera, two (Microsporum and Trichophyton) were isolated. Conclusion: In our centre, non-dermatophytic moulds and yeasts are a lot more prevalent as causative agents of onychomycosis than dermatophytes.

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“…Ayrıca kültürde üreyen dermatofit dışı mikroorganizmaların saprofit ya da kontaminasyon olma ihtimali mevcuttur. Bu nedenle tekrarlayan kültürlerde ve sayı netleştirilemese de toplam ekim alanının %25'inde aynı etkenin üretilmesi ile sonuç kesinleştirilir 18 . Tüm bunlar düşünüldüğünde kültür inceleme onikomikoz tanısında bir tarama testinden çok klinik olarak onikomikozdan şüphelenilen ancak direkt inceleme ile etkenin gösterilemediği durumlarda ya da verilen antifungal tedaviye rağmen tırnak bozukluğu devam eden hastalarda dermatofit dışı etkenleri saptamak ya da antifungal duyarlılık testlerini için kullanılabilir.…”

Section: Bulgularunclassified

Onikomikoz Tanısında Kullanılan 5 Farklı Yöntemin Etkinlik ve Maliyet Karşılaştırması

Erkan¹,

Kaçar²,

Özuğuz³

et al. 2014

TURKDERM

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ÖzetGiriş ve Amaç: Bu çalışmada kliniğimize onikomikoz düşündüren klinik bulgularla başvuran hastalarda tanı testlerinin, tanı koyma etkinlik ve maliyet etkinlik karşılaştırması, tanı yöntemlerini etkileyen faktörlerin belirlenmesi hedeflenmiştir. Gereç ve Yöntem: Altmış bir hastada 5 tanı yöntemi uygulanarak testlerin etkinlik ve maliyeti değerlendirildi. Klinik görünümle birlikte beş tanı yönteminden en az birisi pozitif olan hastalar onikomikoz tanısı aldı. Ayrıca hastaların demografik verileri yanında eşlik eden hastalıklar, tinea pedis ve tinea manum varlığı, önceki antifungal tedavileri gibi test sonuçlarını etkileyebilecek diğer faktörler kaydedildi. Bulgular: Çalışmaya alınan 61 hastanın 50'si (%82) beş tanı yönteminden en az biri pozitif saptanarak onikomikoz tanısı aldı. Tanı yöntemlerinin başarısı 50 olgu için sırasıyla değerlendirildiğinde; standart potasyum hidroksit (KOH) inceleme 34'üne (%68), 24 saatlik KOH inceleme 40'ına (%80), kültür 50 olgudan 24'üne (%48), histopatolojik incelemelerden periodic acid-Schiff (PAS) boyama 34'üne (%68), ''Grocott'un metenamin'' gümüş boyası (GMS) ise 32'sine (%64) doğru tanı koyabilmiştir. Maliyet ilişkisine göre incelendiğinde en ucuz test 24 saatlik inceleme iken en pahalısı histopatolojik incelemeler (PAS-GMS)'dir. Sonuç: Yirmi dört saatlik KOH inceleme dermatoloji pratiğinde farklı bir klinisyen ve laboratuvara ihtiyaç duymadan nispeten hızlı, etkili ve ucuz bir tamamlayıcı yöntem olarak daha sık tercih edilebilir. (Türk derm 2014; 48: 21-5) Anah tar Ke li me ler: Onikomikoz, direkt KOH mikroskopi, 24 saatlik KOH inceleme, mantar kültürü, PAS boyama, GMS boyama Sum maryBackground and Design: We aimed to compare the diagnostic value and cost-effectiveness of the diagnostic tests in patients with clinical findings suggesting onychomycosis as well as to assess the factors that affect these diagnostic tests. Material and Method:We evaluated the efficiency and cost-effectiveness of 5 diagnostic methods in 61 patients. Patients with at least one positive test, in addition to the the clinical picture, received the diagnosis of onychomycosis. Besides demographical features, we recorded factors such as presence of accompanying systemic diseases, tinea pedis and tinea manum, and previous antifungal treatment which may affect test results. Results: Fifty patients out of 61 were diagnosed as having onychomycosis by positivity of at least one of the five methods. The success rate of the diagnostic methods in 50 patients was as follows: standard potassium hydroxide (KOH) microscopy in 34 (68%) patients, 24-hour KOH microscopy in 40 (80%), fungal culture in 24 (48%), periodic acid-Schiff (PAS) staining in 34 (68%) and Grocott's methenamine silver staining (GMS) in 32 (64%) patients. When cost-effectiveness was considered, 24-hour KOH microscopy testing was the most efficient and the cheapest whereas histopathological tests were the most expensive methods. Conclusion: Twenty-four-hours KOH testing is relatively fast, efficient and cost-effective complementary method that do...

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Systematic review of nondermatophyte mold onychomycosis: Diagnosis, clinical types, epidemiology, and treatment

Cited by 225 publications

References 46 publications

Prognostic Factors in Onychomycosis Treatment

Prognostic Factors in Onychomycosis Treatment

Non-dermatophytic moulds and yeasts as agents of onychomycosis in a Malaysian medical centre

Onikomikoz Tanısında Kullanılan 5 Farklı Yöntemin Etkinlik ve Maliyet Karşılaştırması

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