Onychomycosis in children: a survey of 46 cases

Abstract

This is a retrospective study of the agents, clinical aspects, sources of infection and therapy of onychomycosis in children. In the period 1989-2000, we observed 46 consecutive children, until 16 years of age with onychomycosis (29 boys, 17 girls, mean age 10.8 years). Dermatophytes were isolated in 30 cases (Trichophyton rubrum in 22 cases, Trichophyton mentagrophytes in five, Epidermophyton floccosum in two and Trichophyton violaceum in one) and Candida spp. in 16, associated with Trichophyton rubrum in two. Moulds were isolated in three children (Fusarium oxysporum in one, Scopulariopsis brevicaulis in another and Aspergillus fumigatus associated with Trichophyton rubrum in a third). The commonest features were distal and distolateral subungual hyperkeratosis in dermatophyte infections (93%) and onychodystrophy and paronychia in Candida infections (56% and 50% respectively). Forty patients achieved clinical and mycological recovery. It is appropriate to suspect onychomycosis in children, perform microbiological diagnosis and undertake early treatment. An approach of this kind may help to prevent nail dystrophy and the spread of infection.

Onychomycosis in Children: An Experience of 59 Cases

“…In the case of fingernail onychomychosis, patients less than 3 years old comprised the highest proportion (40.0%) as in the report by Lange et al8 On the contrary to other reports, the incidence tended decrease with age. Male children were more likely to present with onychomycosis in female children (1.95 : 1) as reported by Choi et al17, Lateur et al5 and Romano et al6.…”

“…In a study by Gupta et al4, the concurrent rate reached 47.0%. It is known that onychomycosis is more likely to occur in patients with Down syndrome or with human immunodeficiency virus (HIV) infection4-6,9,13-15. In this study, however, there was no patient with Down syndrome or HIV infection.…”

In vitro activity of voriconazole against dermatophytes, Scopulariopsis brevicaulis and other opportunistic fungi as agents of onychomycosis

“…The most commonly isolated dermatophyte is Trichophyton rubrum, followed by Trichophyton interdigitale and Trichophyton mentagrophytes [3,4]. Epidermophyton floccosum has also been implicated in toenail infections [5].…”

Review of Treatment for Onychomycosis: Consideration for Special Populations

“…[28][29][30] The most common type of onychomycosis in children is DLSO, usually caused by the pathogen T. rubrum. 28,29,31,32 Terbinafine therapy achieved a complete cure in 32 of 41 children reported in the medical literature. 33 Itraconazole capsules used for fingernail or toenail T. rubrum onychomycosis in 63 children produced complete cure in 49 cases.…”