Non‐dermatophyte mould onychomycosis: a clinical and epidemiological study at a dermatology referral centre in Bogota, Colombia

Abstract

Worldwide prevalence of non-dermatophyte mould onychomycosis has increased in recent years; however, available information on the topic is confusing and oftentimes contradictory, probably due to the small number of reported cases. The aim of this study was to determine and describe the aetiological agents, as well as the epidemiological and clinical characteristics of non-dermatophyte mould onychomycosis in a dermatology referral centre in Bogota, Colombia. A cross-sectional descriptive study was conducted between January 2001 and December 2011 among patients who attend the National Institute of Dermatology with a confirmed diagnosis of onychomycosis by non-dermatophytes moulds. There were 317 confirmed cases of non-dermatophyte mould onychomycosis in 196 women and 121 men whose average age was 43 years. Twenty-seven per cent of them had a history of systemic disease. The habit of walking and showering barefoot was the major infection-related factor. Distal and lateral subungual presentation was the most common pattern of clinical presentation. The most frequent non-dermatophyte mould was Neoscytalidium dimidiatum followed by Fusarium spp. No relationship was observed with predisposing factors previously reported in the literature. Clinical features found in this population are indistinguishable from onychomycosis caused by dermatophytes. High prevalence of N. dimidiatum found here was in contrast to a large number of studies where other types of moulds predominate.

Genotyping of Fusarium Isolates from Onychomycoses in Colombia: Detection of Two New Species Within the Fusarium solani Species Complex and In Vitro Antifungal Susceptibility Testing

“…In other studies, onychomycosis has more often been diagnosed in women than men [12][13][14][15], a trend which might be skewed by gender differences, e.g., women are more likely to schedule dermatology appointments. Nevertheless, this variable was not statistically significant to our study, as reported by Diepeningen et al [8].…”

“…Results from the sequence analysis show that nine phylogenetic species (seven previously described and two potentially new) were involved in the 89 cases of fusariosis studied. Although previous studies have already reported that F. solani, F. oxysporum, and F. verticillioides were involved in cases of onychomycosis in Colombia, phylogenetic evaluation of the infecting isolates was not evaluated [13][14][15]49].…”

“…In general, a prevalence of Fusarium in dermatological infections has been reported to range between 2 and 8 % [6][7][8], but this is particularly higher in Colombia, being estimated at 15-30 % [9][10][11][12][13]. In two studies, conducted in 2003 and 2009 in Medellín and Bogotá, respectively, Fusarium solani was the most frequent cause of onychomycosis, followed by Fusarium oxysporum and Fusarium verticillioides [14,15], although the distribution of Fusarium species in dermatological infections varies around the world.…”

Distinct characteristics of Scytalidium dimidiatum and non‐dermatophyte onychomycosis as compared with dermatophyte onychomycosis

“…Risk factors for onychomycosis included host factors and environmental factors. Many predisposing factors, such as closed contact with soil surface and agricultural labor, were proposed and thought to be probably related to NDM onychomycosis but without supportive statistical analysis …”

“…Studies on clinical presentations, demographic data and predisposing factors to NDM infection, Scytalidium spp. in particular, as well as the comparison of those between DMP and NDM onychomycosis, were limited or observed without statistical analysis . This study focused on demographic data, risk factors and clinical manifestations of patients with onychomycosis and aimed to compare these characteristics between DMP and NDM subpopulations by statistical analysis.…”