Frequency, type and treatment of fungal pathogens in toenail onychomycosis in the central Alpine region of South Tyrol, northern Italy – a 10‐year retrospective study from 2004 to 2013

Abstract

Onychomycosis is one of the most common dermatological diseases, primarily caused by dermatophytes, and sometimes, also by yeast and moulds. This study aims to clarify the frequency of isolated pathogens from mycotic toenails in the reference centre of the central Alpine mountain region of South Tyrol, northern Italy. Age and gender differences, types of pathogens and initial therapy used were also investigated. This is a retrospective study from 2004 to 2013 on the files of all patients with suspected onychomycosis in whom a cultural pathogen detection was performed. A total of 1565 patients were studied (943 women; 622 men), with a median age of 55 years. Fungal pathogens could be detected by culture in 49.5%. Significantly more pathogens could be grown in men (63.8%) than in women (39.9%, P < 0.0001). The most common pathogens grown were dermatophytes (53.3%), especially T. rubrum and T. interdigitale, followed by moulds (24.7%) and yeast (22%). Therapies prescribed were topical in 64.2% and systemic in 35.8% of the cases. Topical treatment was more frequent in older patients (P < 0.05). In northern Italy, dermatophytes are the most common causative agents for onychomycosis. Fungal pathogens were more commonly found in men than in women and topical treatment was more frequent in older patients.

Fractional Carbon-Dioxide Laser Plus Topical Clotrimazole versus Oral Itraconazole plus Topical Clotrimazole for Onychomycosis: A Randomized, Controlled Trial

“…In the present study, there was more female than male patients (60% versus 40%). Similar results were found by previous studies [7,9,27,28]. The difference might result from daily habits such as nail cosmetics, frequent water contact, detergents, raw food, cleaning materials, hydrocarbons, and trauma.…”

Global prevalence of onychomycosis in general and special populations: An updated perspective

“…Sufficient data were available to compare the prevalence of NDM onychomycosis in clinically suspected patients who underwent single ( n = 81,515) or repeat sampling ( n = 32,171) 16,50–112 . Across both Global North and Global South regions, results from studies where single sampling is performed showed a higher degree of variability compared to studies that utilized the recommended repeat sampling approach (Figure 3).…”

In vitro Evaluation of Photodynamic Effects Against Biofilms of Dermatophytes Involved in Onychomycosis

“…interdigitale (Faergemann and Baran, 2003). The non-dermatophyte molds, such as Fusarium spp., Acremonium spp., Alternaria spp., Scopulariopsis brevicaulis, Aspergillus spp., can also be involved in the pathogenesis with estimated 10% prevalence worldwide (Gupta and Nakrieko, 2014; Gasser et al, 2016; Gupta et al, 2016; Motamedi et al, 2016). Yeasts, like Candida albicans and Candida parapsilosis , represent the third cause of nail fungal infection, but only occurring when predisposing factors are present, mainly immunosuppression, and diabetes (Arrua et al, 2015; Gasser et al, 2016).…”