Prise en charge des onychomycoses

Lê, Phu Quoc; André, Josette; Richert, Bertrand

doi:10.1016/j.lpm.2014.06.012

Cited by 11 publications

(3 citation statements)

References 14 publications

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“…Effective local antifungal agents include azole derivatives, ciclopiroxolamine, and possibly topical terbinafine. In addition, the most widely used systemic antifungal agents are fluconazole (150-300 mg/d one day a week) and itraconazole (400 mg/d one week a month) [24,26]. Treatment of esophageal candidiasis is immediately systemic.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological and mycological profile of superficial mycoses in diabetic patient

Fatiha Bousnina,

Oumaima Nassiri,

Oumaima kharkhach

et al. 2024

World J. Bio. Pharm. Health Sci.

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Introduction: Superficial mycoses, especially those of nails, scalp and skin, are very common in various countries. The presence of specific terrain, as well as other factors, can affect the prevalence of these. In this sense, diabetic patients are more susceptible to infections especially fungal infections because of changes in the immune system and macro and microvascular changes. The objective of our study was to determine the epidemiological and mycological profile of superficial mycoses in diabetic patients at the Mohammed VI Hospital in Oujda (Morocco). Material and methods: This is a retrospective, observational and descriptive study spread over 34 months, from January 2021 to October 2023 at the Parasitology-Mycology laboratory of the Mohammed VI Hospital Center of Oujda. We collected demographic and mycological data for the included patients. In the laboratory, upon reception of the samples, a direct examination (DE) of the sample was obtained after clarification by KOH to better visualize the mycelial filaments or yeasts and culture on both media: Sabouraud with chloramphenicol and Sabouraud with chloramphenicol and cycloheximide is systematically carried out. Results: We collected 136 diabetic patients referred to our laboratory for suspicion of superficial mycosis. The latter was confirmed in 46 of the 136 diabetic patients (33.82%) referred to our laboratory, which corresponds to 50 lesions among the 166 sites taken, a prevalence of 30.12%. At the mycological examination, the DE allowed the confirmation of the diagnosis of mycoses in 64% (n=32) and showed most often mycelial filaments (n=21; 65.62%) especially at the level of the feet and yeasts were observed in particular at the level of the nails of the hands (n=11; 34.37%). While culture was positive in all cases without exception (100%; n=50), dermatophytes were the most frequently isolated fungi (n=30; 60%), followed by yeasts (n=20; 40%). By species, T. rubrum (n=30; 60%) was the only isolated dermatophyte species, followed by Candida albicans (n=17; 34%). Conclusion: In recent years, we have seen an increase in the prevalence of superficial mycoses in diabetic patients which is why we conducted this study. The results show on the one hand that the most isolated fungi in the superficial mycoses of these patients are dominated by dermatophytes, as T. rubrum represents the most frequently encountered species. Furthermore, the high prevalence of the latter demonstrates the significance of implementing important prevention measures.

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Section: Discussionmentioning

confidence: 99%

Epidemiological and mycological profile of superficial mycoses in diabetic patient

Fatiha Bousnina,

Oumaima Nassiri,

Oumaima kharkhach

et al. 2024

World J. Bio. Pharm. Health Sci.

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“…Also, the nail plate prevents their desiccation, thus preserving a high percentage of moisture ( 5 ). Just like the biofilm site should be eliminated in cases of biofilm infections, many authors believe that OM can be cured only by avulsion (mechanical, chemical or surgical) of the nail ( 4 , 9 , 23 ), together with combined systemic and topical therapies. Since therapy is usually painstaking and lengthy (from three months with a systemic antimycotic to 18 months with topical therapy) ( 1 , 3 , 4 , 6 , 11 ), particular attention should be paid to the factors which are important for reaching an accurate diagnosis.…”

Section: Discussionmentioning

confidence: 99%

The Prevalence of Onychomycosis in the Zagreb Area – the Role of Sabouraud Agar without Cycloheximide in Diagnosis and Therapy

Mendek

Lugović-Mihić

Ferček

et al. 2018

ACC

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SUMMARY – Mycological analysis is considered the gold standard in the diagnosis of very common fungal diseases of nails. The purpose of the article is to present the prevalence of onychomycosis obtained by using direct microscopic examination (DME) and cultivation on Sabouraud media without cycloheximide. The quantitative retrospective research was conducted on 2706 patients of both sexes (mostly middle-aged to elderly) with various toenail lesions, who had undergone mycological analyses in the Mycological Laboratory of our Department of Dermatovenereology in 2013 and 2014. Analysis of the results obtained revealed that there were 35.4% of positive DME results; of these, there were 39.2% of dermatophytes, 59.1% of yeasts and 1.7% of molds. The percentage of dermatophytes ( Trichophyton spp.) was twice as high in men as in women. A considerable percentage (12%) of mixed isolates was also observed. Particularly worrisome was the high percentage (one-third) of suppressed and insufficiently developed dermatophytes (a possible indicator of inappropriate preparation of patients for mycological analysis). Cultivation on culture media without cycloheximide requires frequent inspections because of the fast-growing molds while not allowing sporulation for a great number of dermatophytes. However, it has certain advantages, i.e. it offers an insight into the wide range of the present fungi. As part of the biofilm, they can be potentially pathogenic in dystrophic nails under certain circumstances because, according to our results, the percentage of dermatophytes does not change substantially with aging; however, what does change is the percentage of molds, yeasts and mixed isolates.

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“…Leur traitement est long, les enjeux économiques qui en résultent sont importants, pourtant on constate souvent une stratégie thérapeu-tique peu adaptée, qui entraîne des traitements inutilement prolongés. Il faut ainsi savoir identifier les cinq formes d'onychomycoses à haut risque de résistance au traitement [5]. De nombreuses maladies cutanées, des maladies inflammatoires comme le psoriasis [6], mais aussi la pelade, le lichen plan, des maladies génétiques.…”

Section: Show Me Your Nails!unclassified

Montrez-moi vos ongles !

Lorette¹

2014

La Presse Médicale

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Prise en charge des onychomycoses

Cited by 11 publications

References 14 publications

Epidemiological and mycological profile of superficial mycoses in diabetic patient

Epidemiological and mycological profile of superficial mycoses in diabetic patient

The Prevalence of Onychomycosis in the Zagreb Area – the Role of Sabouraud Agar without Cycloheximide in Diagnosis and Therapy

Montrez-moi vos ongles !

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