Onychomycosis in Children: An Experience of 59 Cases

Abstract

BackgroundAlthough tinea unguium in children has been studied in the past, no specific etiological agents of onychomycosis in children has been reported in Korea.ObjectiveThe purpose of this study was to investigate onychomycosis in Korean children.MethodsWe reviewed fifty nine patients with onychomycosis in children (0~18 years of age) who presented during the ten-year period between 1999 and 2009. Etiological agents were identified by cultures on Sabouraud's dextrose agar with and without cycloheximide. An isolated colony of yeasts was considered as pathogens if the same fungal element was identified at initial direct microscopy and in specimen-yielding cultures at a follow-up visit.ResultsOnychomycosis in children represented 2.3% of all onychomycosis. Of the 59 pediatric patients with onychomycosis, 66.1% had toenail onychomycosis with the rest (33.9%) having fingernail onychomycosis. The male-to-female ratio was 1.95:1. Fourteen (23.7%) children had concomitant tinea pedis infection, and tinea pedis or onychomycosis was also found in eight of the parents (13.6%). Distal and lateral subungual onychomycosis was the most common (62.7%) clinical type. In toenails, Trichophyton rubrum was the most common etiological agent (51.3%), followed by Candida albicans (10.2%), C. parapsilosis (5.1%), C. tropicalis (2.6%), and C. guilliermondii (2.6%). In fingernails, C. albicans was the most common isolated pathogen (50.0%), followed by T. rubrum (10.0%), C. parapsilosis (10.0%), and C. glabrata (5.0%).ConclusionBecause of the increase in pediatric onychomycosis, we suggest the need for a careful mycological examination of children who are diagnosed with onychomycosis.

Epidemiologic Analysis of Onychomycosis in the San Diego Pediatric Population

“…In a sample of 2,500 children younger than 18 years of age in North America, Gupta et al estimated the pediatric prevalence of OM to be 0.44% in North America. Several studies from around the world indicate that the prevalence of onychomycosis in children ranges from 0.2% to 2.6% . The estimated frequency of 1.1% in our cohort of children seen in a pediatric dermatology center and the greater incidence in those 12 to 18 years of age than in those younger than 12 years is consistent with previous literature .…”

Acral manifestations of fungal infections

“…Exactly why this infection is less common in children than in adults is unknown but it is thought to be due to faster nail growth, smaller surface areas available for exposure to onychomycotic pathogens, lack of cumulative trauma, and reduced environmental exposure to public places. 39 A C C E P T E D M A N U S C R I P T…”

Analysis of superficial mycoses in children examined in 2013–2016 in the Unit of Medical Mycology at the Department of Dermatology, Poznan University of Medical Sciences

“…Rare cases of Scedosporium apiospermum ci w porównaniu z dorosłymi, który ma związek z lepszym ukrwieniem [17]. Najpowszechniejsza jest postać dystalna i boczna podpłytkowa grzybicy paznokci [1,18,19]. Stopniowo następuje rogowacenie obrąbków naskórkowych paznokcia, co powoduje oddzielanie się paznokcia od łożyska (onycholizę) [9].…”

“…Distal and lateral subplate onychomycoses are the most common [1,18,19]. Gradual hyponychium keratosis leading to onycholysis takes place [9].…”