Onychomycosis

Ramesh, V; Reddy, B. Naresh Kumar; Singh, Rattan

doi:10.1111/j.1365-4362.1983.tb03352.x

Cited by 46 publications

(20 citation statements)

References 47 publications

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“…In our study the incidence of onychomycosis increases as the age progresses and the association is significant which is similar to that seen by Ramesh et al [11] as the faster rate of nail plate growth prevents onychomycosis in children. The incidence of onychomycosis is higher in females than in males and the only nail involvement is seen more frequently than in association with skin, hair or systemic disease.…”

Section: Onychomycosis (With or Without Paronychia):-supporting

confidence: 90%

To Study Nail Changes in Dermatology.

Mishra¹,

Saraswat²

2017

IJAR

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Section: Onychomycosis (With or Without Paronychia):-supporting

confidence: 90%

To Study Nail Changes in Dermatology.

Mishra¹,

Saraswat²

2017

IJAR

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“…The criterion was later restricted to filamentous fungi by English (11), since widely dispersed yeast contamination had been found to be common. This amended version has been employed in numerous studies over the years (1,22,23), has been recommended in reviews (9,15,19,26,30), and is routinely used in many laboratories.…”

mentioning

confidence: 99%

Utility of Inoculum Counting (Walshe and English Criteria) in Clinical Diagnosis of Onychomycosis Caused by Nondermatophytic Filamentous Fungi

et al. 2001

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Opportunistic onychomycosis caused by nondermatophytic molds may differ in treatment from tinea unguium. Confirmed diagnosis of opportunistic onychomycosis classically requires more than one laboratory analysis to show consistency of fungal outgrowth. Walshe and English in 1966 proposed to extract sufficient diagnostic information from a single patient consultation by counting the number of nail fragments positive for inoculum of the suspected fungus. Twenty fragments were plated per patient, and each case in which five or more fragments grew the same mold was considered an infection by that mold, provided that compatible filaments were also seen invading the nail tissue by direct microscopy. This widely used and often recommended method has never been validated. Therefore, the validity of substituting any technique based on inoculum counting for conventional follow-up study in the diagnosis of opportunistic onychomycosis was investigated. Sampling of 473 patients was performed repeatedly. Nail specimens were examined by direct microscopy, and 15 pieces were plated on standard growth media. After 3 weeks, outgrowing dermatophytes were recorded, and pieces growing any nondermatophyte mold were counted. Patients returned on two to eight additional occasions over a 1-to 3-year period for similar examinations. Onychomycosis was etiologically classified based on long-term study. Opportunistic onychomycosis was definitively established for 86 patients. Counts of nondermatophyte molds in initial examinations were analyzed to determine if they successfully predicted both true cases of opportunistic onychomycosis and cases of insignificant mold contamination. There was a strong positive statistical association between mold colony counts and true opportunistic onychomycosis. Logistic regression analysis, however, determined that even the highest counts predicted true cases of opportunistic onychomycosis only 89.7% of the time. The counting criterion suggested by Walshe and English was correct only 23.2% of the time. Acremonium infections were especially likely to be correctly predicted by inoculum counting. Inoculum counting could be used to indicate a need for repeat studies in cases of false-negative results from laboratory direct microscopy. Inoculum counting cannot serve as a valid substitute for follow-up study in the diagnosis of opportunistic onychomycosis. It may, nonetheless, provide useful information both to the physician and to the laboratory, and it may be especially valuable when the patient does not present for follow-up sampling.

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“…Only 16% of patients presented less than 6 months after the onset of the disease and a few patients presented after more than 10 years. This is perhaps due to the asymptomatic, indolent course of the disease 13,28,30 . In several patients, trauma was a predisposing factor, emphasizing its role in onychomycosis 3,5,30 .…”

Section: Discussionmentioning

confidence: 99%

“…This is perhaps due to the asymptomatic, indolent course of the disease. 13,28,30 In several patients, trauma was a predisposing factor, emphasizing its role in onychomycosis. 3,5,30 A large majority of patients had a habit of wearing shoes, wherein the warmth and moisture provided by occlusive footwear promoted growth of fungus.…”

Section: Discussionmentioning

confidence: 99%