Onychomycosis and Immunodepression

Chang, Patricia; Ucelo, Zonia Maria Quijada; Chávez, Helena Maria del Pilar Garzaro

doi:10.1007/s12281-017-0292-7

Cited by 9 publications

(19 citation statements)

References 29 publications

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“…The incidence of onychomycosis has changed since the use of prophylactic antifungal therapy with fluconazole or itraconazole and the introduction of cART [1, 2], which may improve onychomycosis even without antifungal therapy just by restoration of the immune function [2]. Nonetheless, in published studies it remains up to four times more frequent in these individuals than in the general population [1], with a prevalence of 34.8% and most frequently found in toenails, with only 5% in fingernails and always associated with toenail involvement [10].…”

Section: Discussion/conclusionmentioning

confidence: 99%

“…Nonetheless, in published studies it remains up to four times more frequent in these individuals than in the general population [1], with a prevalence of 34.8% and most frequently found in toenails, with only 5% in fingernails and always associated with toenail involvement [10]. In addition, males are predominantly affected (68.7%), with a male:female ratio of 2.2: 1 [2].…”

Section: Discussion/conclusionmentioning

confidence: 99%

“…Onychomycosis is one of the most common nail diseases and constitutes up to 50% of all nail conditions, present in more than 10% of the worldwide population [1]. It is a chronic fungal nail infection which tends to gradually destruct the nail plate and is considered a source of dissemination for skin dermatophytosis [2].…”

Section: Introductionmentioning

confidence: 99%

“…The possibility of growing a positive culture for onychomycosis increases in patients with a viral load higher than 50 copies/mL [1, 3], and the most frequent clinical presentation is distal and lateral subungual onychomycosis, followed by total dystrophic onychomycosis. Parallel to this, few studies have found fungal organisms invading the nail plate without any clinical manifestations, termed subclinical onychomycosis, with a reported incidence that ranges from 1.5 to 17% depending on the series, so we aimed to study its prevalence in a Mexican HIV-infected population [4].…”

Section: Introductionmentioning

confidence: 99%

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Subclinical Onychomycosis: Not Present in HIV-Positive Population?

Contreras-Rivera

Toussaint–Caire

Fernández‐Martínez

et al. 2018

Skin Appendage Disord

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Background: Onychomycosis is one of the most common nail diseases and constitutes up to 50% of all nail conditions. It is a chronic fungal nail infection common in the HIV-infected population. Few studies have found fungal organisms in the nail without clinical evidence, and thus, termed subclinical onychomycosis. Objectives: We analyzed the nails of the HIV population in our hospital, searching for subclinical onychomycosis. Method: A distal nail clipping was stained with PAS and observed by a trained dermatopathologist. Results: All of our samples (n = 48) turned out to be negative for fungal structures. Conclusions: The epidemiology of onychomycosis is changing, treatment options are much better now, and diagnosis and infection detection are being done earlier. Therefore, we will continue to further study this disease in other patient populations so that we can compare our results and see whether the incidence of onychomycosis in the HIV population is now similar to that in those without HIV infection of the same age.

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Section: Discussion/conclusionmentioning

confidence: 99%

Section: Discussion/conclusionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Subclinical Onychomycosis: Not Present in HIV-Positive Population?

Contreras-Rivera

Toussaint–Caire

Fernández‐Martínez

et al. 2018

Skin Appendage Disord

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“…Furthermore, in DM patients, the reduction of peripheral perfusion and nail morphological changes are also other factors that contribute to make these patients more vulnerable to onychomycosis. 1,2 The isolation and characterisation of fungal agents on the nails (feet and hands) in these patients are crucial for prevention and treatment of onychomycosis. We performed epidemiological, clinical, phenotypic and molecular analysis to compare patients with three different immunosuppressive conditions, as well as the control group of immunocompetent individuals.…”

Section: Introductionmentioning

confidence: 99%

Onychomycosis in immunocompromised population: Phenotypic and molecular identification

Borba,

Ogawa,

Kirsztajn

et al. 2023

Mycoses

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Onychomycosis is common among immunosuppressed individuals. Renal transplant recipients (RTR) and lupus nephritis (LN) patients are submitted to corticosteroid and other immunosuppressive therapy; and diabetes mellitus (DM) patients are intrinsically immunocompromised.ObjectivesThe aim of this study was to characterise and identify fungal infections on the nails (feet and hands) in immunocompromised patients.MethodsThe clinical material, nail scales (foot and/or hand), was collected from 47 RTR, 66 LN, 67 DM, and 78 immunocompetent individuals (control group). Phenotypic and molecular analyses were performed.ResultsA total of 258 patients were examined. There was a female predominance, except in the RTR. The average age was 52 years old. Lateral distal subungual onychomycosis (OSDL) (75.2%), mainly affecting the hallux nail, was frequent. The predominance of dermatophyte on toenails and Candida species on fingernails was statistically significant. A higher frequency of fingernail involvement in LN and DM, and for LN, the difference was significant (p = .0456). Infections by Candida spp. were more frequent in DM. Using molecular methods, 87.2% of diagnoses were confirmed, identifying fungal agents at the species level. Dermatophytes, Trichophyton rubrum and Trichophyton interdigitale and the species of Candida, C. parapsilosis and C. albicans, were the most frequent fungal agents.ConclusionsMolecular techniques (sequencing of ITS regions of rDNA) offer greater accuracy, although there is no difference, regarding the detection. Clinical presentation and fungal species may differ somewhat from the general population. Immunosuppression did not increase fungal detection positivity.

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HIV and the Skin

Bunker,

Piguet

2024

Rook's Textbook of Dermatology

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Within 2 years of defining acquired immune deficiency syndrome (AIDS) as a distinctive syndrome in 1981, human immunodeficiency virus (HIV) was identified as the causative agent. Dermatological involvement in AIDS has been appreciated since the disease was first recognised. Mucocutaneous involvement establishes criteria for diagnosis and staging; the prognostic significance of some complications, for example pruritic papular eruption/eosinophilic folliculitis, hairy leukoplakia and Kaposi sarcoma (KS), was well recognised before specific treatments were introduced. The proportion of patients with skin complications and the number of these manifestations in any one patient increase as HIV infection progresses and AIDS develops. The incidence and severity of several common cutaneous diseases (such as mollusca, herpes simplex and seborrhoeic dermatitis) are increased in patients with HIV and this correlates in many instances with the absolute numbers of CD4+ T cells. The effect HIV infection may have on some dermatological conditions such as psoriasis and leprosy is less clear‐cut. The advent of highly active combined antiretroviral therapy (ART) has been incalculably beneficial to patients with HIV, but novel side effects of these drugs (such as lipodystrophy) have emerged, and the skin can be affected by manifestations of the immune reconstitution inflammatory syndrome/immune reconstitution associated disease. The dermatological complications of HIV and AIDS may be distressing to patients and difficult for dermatologists to diagnose and manage. Also, many dermatoses presenting in the population at large need to be regarded as ‘indicator conditions’ to prompt advice about, and initiation of, HIV testing.

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Onychomycosis and Immunodepression

Cited by 9 publications

References 29 publications

Subclinical Onychomycosis: Not Present in HIV-Positive Population?

Subclinical Onychomycosis: Not Present in HIV-Positive Population?

Onychomycosis in immunocompromised population: Phenotypic and molecular identification

HIV and the Skin

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