Epidemiologic Analysis of Onychomycosis in the San Diego Pediatric Population

Totri, M.A.S. Christine R.; Feldstein, Stephanie; Admani, Shehla; Friedlander, Sheila Fallon; Eichenfield, Lawrence F.

doi:10.1111/pde.12986

Cited by 29 publications

(21 citation statements)

References 23 publications

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“…The high prevalence of fungal infections in North America is largely due to the immigration of dermatophytes from other areas of the world such as West Africa and Southeast Asia. The global prevalence of onychomycosis is estimated to be around 5.5%, attributing to 50.0% of all nail disease cases . The risk of onychomycosis increases with age due to poor peripheral circulation, diabetes, repeated nail trauma, longer exposure to pathogenic fungi, suboptimal immune function, inactivity, and/or the inability to maintain good foot care .…”

Section: Epidemiologymentioning

confidence: 99%

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Global perspectives for the management of onychomycosis

et al. 2018

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Onychomycosis is a fungal nail infection caused by dermatophytes, nondermatophyte molds, and yeasts. This difficult‐to‐treat chronic infection has a tendency to relapse despite treatment. This paper aims to offer a global perspective on onychomycosis management from expert physicians from around the world. Overall, the majority of experts surveyed used systemic, topical, and combination treatments approved in their countries and monitored patients based on the product insert or government recommendations. Although the basics of treating onychomycosis were similar between countries, slight differences in onychomycosis management between countries were found. These differences were mainly due to different approaches to adjunctive therapy, rating the severity of disease and use of prophylaxis treatment. A global perspective on the treatment of onychomycosis provides a framework of success for the committed clinician with appreciation of how onychomycosis is managed worldwide.

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Section: Epidemiologymentioning

confidence: 99%

“…The prevalence of childhood onychomycosis ranges worldwide from 0.35% to 5.5%, causing 15.5% of all child nail dystrophies . Recent studies have suggested that the occurrence of onychomycosis in children has increased .…”

Section: Special Populationsmentioning

confidence: 99%

Global perspectives for the management of onychomycosis

et al. 2018

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“…Onychomycosis is a fungal infection of the nail unit commonly caused by dermatophytes . Recent studies suggest that onychomycosis has a worldwide prevalence of 5.5%, with a 8.9% prevalence in hospital‐based studies and 4.3% in population‐based studies . Recurrence and relapse are frequently (10–53%) associated with this infection despite the use of treatment, with relapse likely to occur within 2.5 years after successful treatment .…”

Section: Introductionmentioning

confidence: 99%

A practical application of onychomycosis cure – combining patient, physician and regulatory body perspectives

Gupta

Versteeg

Shear

2018

Acad Dermatol Venereol

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Due to the high relapse rates and the rise of predisposing factors, the need for curing onychomycosis is paramount. To effectively address onychomycosis, the definition of cure used in a clinical setting should be agreed upon and applied homogeneously across therapies (e.g. oral, topical and laser treatments). In order to determine what is or what should be used to define cure in a clinical setting, a literature search was conducted to identify methods used to evaluate treatment success. The limitations, strengths, prevalence and utility of each outcome measure were investigated. Seven ways to measure treatment success were identified; mycological cure, patient/investigator assessments, complete cure, quality of life instruments, severity indexes, clinical cure and temporary clearance. Despite its shortcomings, mycological cure is the most objective and consistent outcome measure used across onychomycosis studies. It is suggested that diagnostic goals of onychomycosis should be used to define cure in a clinical setting. Modifications to outcome measures such as incorporating molecular-based techniques could be a future avenue to explore.

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“…The incidence of pediatric onychomycosis appears to be increasing. Gupta et al reported a prevalence of 0.44% in 1997 in North American children, and Totri et al documented a 1% incidence of onychomycosis in a 2017 retrospective study. An increase in pediatric onychomycosis has also been observed in India, Spain, Iceland, Poland, Israel, and Turkey …”

Section: Discussionmentioning

confidence: 99%

“…Onychomycosis in children (0.14%) is less frequent than in adults (3.2%) . The prevalence of childhood onychomycosis ranges worldwide from 0.35% to 5.5% and is reported to cause 15.5% of all nail dystrophies in children . A number of studies have demonstrated an increase in the occurrence of onychomycosis in children .…”

Section: Introductionmentioning

confidence: 99%

Onychomycosis in children: Safety and efficacy of antifungal agents

Gupta

Mays

Versteeg

et al. 2018

Pediatric Dermatology

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Onychomycosis is an uncommon condition in childhood, but prevalence in children is increasing worldwide.The objective was to review the efficacy and safety of systemic and topical antifungal agents to treat onychomycosis in children. Databases (Pubmed, OVID, Scopus, clinicaltrials.gov, Cochrane Library) were searched. Seven studies were selected for inclusion. Only one was a randomized controlled trial. In total, 208 children were administered antifungal agents for the treatment of onychomycosis. Four reports of mild adverse events were documented (1.9% of treated children), one of which discontinued treatment (0.5%). Limitations of this review are the lack of randomized controlled trials available in pediatric onychomycosis. These findings suggest that antifungal therapies used to treat onychomycosis in children are associated with a low incidence of adverse events. Current dosing regimens for antifungal drugs are effective and appear safe to use in children, notwithstanding that the Food and Drug Administration has not approved any of these agents for the treatment of onychomycosis in children. To our knowledge, this review is the most up-to-date, comprehensive summary of pediatric onychomycosis treatment.

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Epidemiologic Analysis of Onychomycosis in the San Diego Pediatric Population

Abstract: Our study provides important regional information regarding epidemiologic data in pediatric onychomycosis, highlighting the diagnostic methods most commonly used and the pathogens most frequently encountered in our practice.

Cited by 29 publications

References 23 publications

Global perspectives for the management of onychomycosis

Global perspectives for the management of onychomycosis

A practical application of onychomycosis cure – combining patient, physician and regulatory body perspectives

Onychomycosis in children: Safety and efficacy of antifungal agents

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