Superficial white onychomycosis in a 3‐year‐old human immunodeficiency virus‐infected child

Abstract

We report a case of superficial white onychomycosis associated with HIV infection in a 3-year-old girl. To our knowledge, this type of onychomycosis has not been previously reported in HIV-infected prepubertal children.

Antifungal therapy for onychomycosis in children

“…Young children, however, have thin, fast-growing nails, enabling easier drug penetration (11). This makes them particularly well suited for topical monotherapy, as cure can usually be achieved more easily and faster than in adults (9,(32)(33)(34)(35)(36)(37). In addition, topical monotherapy, when appropriate, alleviates concerns regarding drug toxicity and laboratory monitoring associated with systemic therapy.…”

“…In adults, it is applied once or twice weekly for six to 12 months (46), though it appears that cure is often achieved faster in children (35,36). Clinical trials on adults have shown good efficacy with amorolfine monotherapy, with a mycological cure rate ranging from 60-76% and complete cure rate somewhat lower, ranging from 12.7-54% (47,48).…”

“…A 3-year-old HIVpositive child with T. rubrum superficial white onychomycosis involving the second, third, fourth and fifth toes of her left foot was treated with topical amorolfine monotherapy and achieved substantial improvement within 4 weeks (35). A 20-monthold girl with distal nail thickening and discoloration of her fingernail was treated with 5%…”

Case of infantile onychomycosis successfully cured by 5% amorolfine nail lacquer

“…Diabetes, psoriasis and other diseases may also increase the risk of infection. 2,3 In those health individuals who are affected, there may be a family history of onychomycosis as our patient, which gives importance to the examination of the whole family for fungal nail infections.…”

Treatment of Onychomycosis: Pros and Cons of Antifungal Agents

“…In a case study, amorolfine 5% nail lacquer applied once per week in a 3-year-old HIV-infected child had a good response within 4 weeks. 42 Diabetics Diabetics who are type I or type II, with sensory neuropathy and impaired circulation of the lower extremities, have an increased risk of experiencing complications from onychomycosis. The fungal disease may result in sharp and pointed nails that can cause injury to the surrounding skin.…”