The prevalence and etiological factors of onychomycosis in psoriatic patients

Romaszkiewicz, Alicja; Bykowska, Barbara; Zabłotna, Monika; Sobjanek, Michał; Sławińska, Martyna; Nowicki, Roman

doi:10.5114/pdia.2017.68299

Cited by 16 publications

(22 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It has been reported that psoriasis patients are more likely to develop onychomycosis than the general population [ 8 , 33 , 34 ]. Nevertheless, considering that both onychomycosis and nail psoriasis usually present with similar clinical features leading to difficult discrimination and ambiguous results, some reports indicate no differences in prevalence rates between psoriasis and non-psoriasis patients with clinical nail abnormalities [ 35 , 36 ].…”

Section: Discussionmentioning

confidence: 99%

Onychomycosis in Northwestern Greece over a 7-Year Period

et al. 2020

View full text Add to dashboard Cite

Onychomycosis is considered as one of the major public health problems with a global distribution associated with geographic, demographic and environmental factors, underlying comorbidities and immunodeficiency disorders. This study was conducted to investigate the etiological agents of onychomycosis, in Northwestern Greece during a 7-year period. The study population included 1095 outpatients with clinically suspected onychomycosis that presented to the University Hospital of Ioannina, NW Greece (2011–2017). Samples were examined for causative fungi, and mycological identification was established using standard mycological methods. Demographic data of each patient, comorbidities, localization of infection and history of previous fungal infection were collected. Onychomycosis was diagnosed in 317 of the 1095 suspected cases (28.9%) and the most frequently isolated pathogens were yeasts (50.8%) followed by dermatophytes (36.9%) and non-dermatophyte molds (NDMs) (12.3%). Dermatophytes were mostly involved in toenail onychomycosis (90.6%) and more commonly affected males than females (57.3% vs. 42.7%), while the predominantly isolated pathogen was Τrichophyton rubrum (74.4%) followed by Τrichophyton interdigitale (21.4%). Candida albicans was the most prevalent isolated yeast (82%), whereas among the cases with onychomycosis due to NDMs, Aspergillus spp. were isolated as the principal species (59%). Continuous monitoring should be performed in order to identify possible trends and shifts in species isolation rates and to evaluate the impact of onychomycosis among the general population and high-risk groups.

show abstract

Section: Discussionmentioning

confidence: 99%

Onychomycosis in Northwestern Greece over a 7-Year Period

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Epidemiological studies conducted to estimate the prevalence of onychomycosis in psoriatic patient provide ambiguous results. Some authors indicate that onychomycosis affects up to 79% of psoriatic patients, and the others show a low incidence of onychomycosis (15%) in this group …”

Section: Introductionmentioning

confidence: 98%

A 15‐year retrospective study on the prevalence of onychomycosis in psoriatic vs non‐psoriatic patients: A new European shift from dermatophytes towards yeast

Gallo

Cinelli

Fabbrocini

et al. 2019

Mycoses

View full text Add to dashboard Cite

Summary Because of their similar clinical presentation, discrimination between nail psoriasis and onychomycosis often is difficult. We aim to investigate the actual frequency of onychomycosis in psoriatic patients and to compare it between psoriatic and non‐psoriatic patients. This retrospective study included a total of 9281 patients, referring to our Mycology Laboratory from September 2003 to May 2018. The patients are divided into two groups: PsoGroup (patients with psoriasis) and non‐PsoGroup (non‐psoriatic patient). Direct microscopic examination with 20% KOH and culture was carried out in both groups. In PsoGroup (711 patients, 59.50% female, 40.50% male, median age of 52.22 ± 15.01), the prevalence of onychomycosis was 49.08%. On the other hand, in non‐PsoGroup (8570 patients (71.65% female, 28.35% male, median age of 48.51 ± 19.31 years), the prevalence of onychomycosis was 51.30%. There was no statistically significant difference between the prevalence of onychomycosis in PsoGroup 49.08% (349/711) compared to 51.30% (4397/8570) of non‐PsoGroup (P = 0.2578). However, yeasts were significantly more prevalent in non‐psoriatic than in psoriatic patients (P = 0.0144.). In our Mycological Laboratory, we observed a similar prevalence of onychomycosis in psoriatic patients and non‐psoriatic patients. However, the spectrum of fungal species isolated was different from each other, with a higher prevalence of yeasts in non‐PsoGroup that reflect a recent oriental trends.

show abstract

“…Pits was the most common finding in our study while others have reported ridging and pitting to be the most common [25] . It can readily be appreciated that ridging and pitting themselves contribute towards roughening of nail plate [26] . Pitting of nail plate in psoriasis is due to a defective formation of nail plate in the proximal part of nail matrix.…”

Section: Discussionmentioning

confidence: 99%

Clinical profile and severity of nail involvement in psoriasis

Rao¹,

Yakkala²

2021

Int. J. Dermatol. Venereology Leprosy Sci.

View full text Add to dashboard Cite

Introduction: Psoriasis is the skin disease that most frequently affects the nails. Depending on the very nail structure involved, different clinical nail alterations can be observed. Irritation of the apical matrix results in psoriatic pits, mid-matrix involvement may cause leukonychia, whole matrix affection may lead to red lunulae or severe nail dystrophy. Material and Methods: This is prospective and observational study conducted in the Department of Dermatology. Dermatological examination specified the clinical form of psoriasis, nail alterations type, and number of fingernails involved, the Psoriasis Area and Severity Index (PASI) score assessing the severity of skin involvement, and based on PASI score, patients were classified into mild (PASI<10), moderate (PASI 10-20), and severe disease (PASI>20). Nail Area Psoriasis Severity Index (NAPSI) score assessing the severity of nail involvement (pitting, leukonychia, red spots in lunula, and nail plate crumbling) and for nail bed disease (oil drop [salmon patch] discoloration, onycholysis, nail bed hyperkeratosis, and splinter hemorrhage). Results: A total of 70 patients were examined. Of the 70 cases, male preponderance was noted. Thirtyfive had early-onset psoriasis and the other 35 had late-onset disease. 48/70 (73%) patients with psoriasis had nail involvement. Among patients with nail involvement as well as those without nail involvement, the patients with mild psoriasis (PASI<10) accounted for the majority (31/48 [64.2%] and 18/22 [81.8%], respectively). Patients with moderate psoriasis accounted for 33.3% (14/48) of those with nail involvement and 9.0% (2/22) of those without nail involvement. Those with severe psoriasis (PASI>20) accounted for 10.4% (5/73) of patients with nail involvement. The most common finding among those with nail changes was pitting (33/48, 89.5%). Other common changes were leukonychia (27/48, 56.2%), Red spots in lunula (3/48, 6.25%), Splinter hemorrhage (9/48, 18.7%), Beau's lines (6/48, 12.5%), and Rough nails (18/48, 37.5%). Conclusion:The most frequent signs of nail matrix disease are pitting, leukonychia, crumbling, and red spots in the lunula, whereas salmon patches or oil spots, subungual hyperkeratosis, onycholysis, and splinter hemorrhages represent changes of nail bed psoriasis. The treatment of nail psoriasis is prolonged with both conventional and biologic therapies and the systemic side effects of the various therapies limit their use. Hence, it requires patience both on the part of the treating dermatologist and the patient.

show abstract

The prevalence and etiological factors of onychomycosis in psoriatic patients

Cited by 16 publications

References 21 publications

Onychomycosis in Northwestern Greece over a 7-Year Period

Onychomycosis in Northwestern Greece over a 7-Year Period

A 15‐year retrospective study on the prevalence of onychomycosis in psoriatic vs non‐psoriatic patients: A new European shift from dermatophytes towards yeast

Clinical profile and severity of nail involvement in psoriasis

Contact Info

Product

Resources

About