A large-scale North American study of fungal isolates from nails: The frequency of onychomycosis, fungal distribution, and antifungal susceptibility patterns

Ghannoum, Mahmoud A.; Hajjeh, Rana; Scher, Richard; Konnikov, Nellie; Gupta, Aditya K.; Summerbell, Richard C.; Sullivan, Sabra; Daniel, Ralph; Krusinski, Paul A.; Fleckman, Philip; Rich, Phoebe; Odom, Richard B.; Aly, Raza; Pariser, David M.; Zaiac, Martin; Rebell, Gerbert; Lesher, Jack L.; Gerlach, B.; Ponce-de-Leon, G. F.; Ghannoum, A.; Warner, Judith E. A.; Isham, N.; Elewski, Boni E.

doi:10.1067/mjd.2000.107754

Cited by 455 publications

(420 citation statements)

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“…[9] The prevalence is higher (25%) in patients with human immunodeÞ ciency virus infection (HIV). [10] Several studies have shown that prevalence of onychomycosis increases with age, reasons for which may include poor peripheral circulation, diabetes, repeated nail trauma, longer exposure to pathogenic fungi, sub optimal immune function, inactivity or the inability to cut the toe nails or maintain good foot care. [7] As is the case among adults, prevalence rates for onychomycosis among children are quite variable: a recent review of studies of the subject in several countries lists prevalence rates varying from 0% (United states, Wales and Finland) to 2.6% (Guatemala).…”

Section: Epidemiology and Risk Factorsmentioning

confidence: 99%

Onychomycosis - epidemiology, diagnosis and management

Kaur

Kashyap

2008

Indian J Med Microbiol

155

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Onychomycosis is a fungal infection of nails caused by dermatophytes, yeasts or nondermatophyte molds and represents about 30% of mycotic cutaneous infections. Increasingly onychomychosis is being viewed as more than a mere cosmetic problem. In spite of improved personal hygiene and living environment, onychomycosis continues to spread and persist. The prevalence rate of onychomycosis is determined by age, predisposing factor, social class, occupation, climate, living environment and frequency of travel. Onychomycosis in immunocompromised patients can pose a more serious health problem. Dermatophytes are the most frequently implicated causative agents in onychomycosis. Previously regarded as contaminants, yeasts are now increasingly recognised as pathogens in Þ ngernail infections, as are some moulds. Clinical diagnosis of onychomycosis is based on the patients' history; a physical examination, microscopy and culture of nail specimens. The treatment of onychomycosis has been attempted throughout the ages, but only in the last two decades have safe, effective systemic treatments been available for this chronic superÞ cial fungal disease. Oral Griseofulvin and Ketoconazole; once the agents of choice for the treatment of onychomycosis, have been superseded by newer systemic compounds that have a higher cure and lower relapse rates, cause fewer side effects and are suitable for short-term dosing.

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Section: Epidemiology and Risk Factorsmentioning

confidence: 99%

Onychomycosis - epidemiology, diagnosis and management

Kaur

Kashyap

2008

Indian J Med Microbiol

155

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“…However, none of them was methodologically designed to detect false-negative and falsepositive results. [1][2][3][4][5][6][7] This can mask a more detailed assessment of the potential use of mycological culture as golden standard test for the diagnosis of onychomycosis. [8][9] The objective of this prospective study is to determine the concordance between the direct microscopic examination (DME) and the culture for fungi on the diagnosis of onychomycosis of the feet.…”

confidence: 99%

Concordance between direct microscopy and fungical culture for the diagnostic of feet's onychomycosis

Souza

Vettorato

Pinto

et al. 2012

An. Bras. Dermatol.

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Prospective study compared the agreement between the direct microscopy and fungical culture from subungueal samples of the patients with clinical suspicion of feet's onychomycosis. The agreement occurred in 56.1% of the exams with dermatophytes, in 52.4% by others fungi and in 90.4% of the negative cases, 0,54 according to the Kappa`s test. In 39.3% of the onychomycosis caused by dermatophytes and 31.8% by nondermatophytes, these were identificated only for direct microscopy. The direct microscopic showed more sensibility compared with the culture, being superior in 19.5% of the total sample and maintaining agreement with the culture in 71.5% of the sample.

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“…The prevalence of onychomycosis in the North American adult population may range from 2% to 18%, with prevalence increasing to 20% and 30% for those older than 60 years and 70 years, respectively. [1][2][3][4][5] Onychomycosis is commonly associated with tinea pedis. Significant physical and psychological effects, such as pain and negative self-image, may occur in patients with onychomycosis.…”

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confidence: 99%