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Rev. chil. pediatr ; 91(1): 131-138, feb. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1092798


Resumen: La onicomicosis (OM) es una infección fúngica de las uñas, cuyo principal agente causal es el Tricophytum rubrum. Si bien es una patología infrecuente en niños, se ha observado un aumento en la prevalencia en el último tiempo. Hasta la fecha, existen diversos estudios y guías clínicas de OM en adultos. Sin embargo, la literatura en edad pediátrica es escasa, lo que dificulta el tratamiento en pediatría. En el presente articulo se revisa la literatura actual, los métodos diagnosticos de OM, datos epidemiológicos locales y globales, y se presentan las opciones de tratamiento disponibles conside rando su eficacia y perfil de seguridad en población pediátrica.

Abstract: Onychomycosis (OM) is a fungal infection of the nails, whose main etiologic agent is Trichophytum rubrum. Although, it is an unusual pathology in children, in the last years an increase in its preva lence has been observed. To date, there are several studies and clinical guidelines for OM in adults. However, literature in children is scarce, which makes pediatric treatment difficult. The objective of this publication was to review the current literature in order to establish diagnostic methods for OM, national and international epidemiological data, and to provide treatment options taking into account their efficiency and safety profile in the pediatric population.

Humans , Infant , Child, Preschool , Child , Adolescent , Onychomycosis/diagnosis , Onychomycosis/microbiology , Onychomycosis/drug therapy , Onychomycosis/epidemiology , Pediatrics , Global Health , Antifungal Agents/therapeutic use
Rev. Hosp. Clin. Univ. Chile ; 28(3): 177-180, 20170000. tab
Article in Spanish | LILACS | ID: biblio-970212


Onychomicosis was considered uncommon in children. During recent years an increase in its frequency has been reported in children worldwide. This survey was carried out to estimate the frequency of causal agents of fungal nail infections in children and adolescents (0-15 years of age) during the period 2006-2016 in the Skin Laboratory of Clinical Hospital, University of Chile. It was a descriptive, retrospective analysis of all positive culture of children nails. A total of 1626 culture was analyzed. Cultures were positive in 417 cases (25,6%). Average age of patients with positive culture was 9,37 ages. Of the total positive culture, 42,9% was females and 57,1% was males. Toenails were more affected (90,6%) than finger nails. Trichophyton rubrum (66,9%), was the predominant pathogen isolated followed by Candida spp (26,1%) Trichophyton rubrum + Candida spp (3,8%) Trichophyton mentagrophytes (2,6%) and Trichophyton rubrum + Trichophyton mentagrophytes (0,5%). Fungal fingernail infection by Candida spp. was the most common (66,7%) and Trichophyton rubrum was the most common in toenail (70,6%). We found a decrease of Candida spp. with age. The results of our study show that onycomichosis in children and adolescents is not exceptional and should be considered in the differential diagnosis of nail plate disorder in children. (AU)

Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Onychomycosis/diagnosis , Onychomycosis/epidemiology
An. bras. dermatol ; 91(2): 173-179, Mar.-Apr. 2016. tab, graf
Article in English | LILACS | ID: lil-781362


Abstract BACKGROUND: Although dermatophytes are considered the major cause of onychomycosis, many reports have incriminated non-dermatophyte moulds and yeasts in the disease’s etiology. Successive Trichosporon isolation from onychomycosis has led to the genus being suspected as a nail primary pathogen. OBJECTIVE: To determine the prevalence of Trichosporon isolation in onychomycosis patients who attended a mycology diagnostic service in Rio de Janeiro, Brazil, between January 2003 and December 2006. The study also includes a worldwide review on Trichosporon isolation prevalence in ungueal disease, emphasizing T. ovoides. METHODS: This retrospective study was conducted with the support of staff from the Mycology Laboratory at the Dermatological Service of Rio de Janeiro’s Santa Casa da Misericórdia (MLDS). RESULTS: Mycological analysis provided positive results equaling 47/5036 (0.93%) for Trichosporon spp.; obtained mainly as a single agent (72.35%), and from mixed cultures (27.65%; X2= 6.397; p= 0.018). The great majority belongs to the T. ovoides species (91.5%; n=43), obtained as a single isolate (74.41%; n= 32/43; X2 = 7.023; p= 0.014). CONCLUSIONS: Although T. ovoides is classically associated as an etiologic agent of white piedra, this study highlights its potential as a human nail disease pathogen. Our study opens doors for future epidemiologic and virulence factors aimed at determining whether T. ovoides is an important causative agent of onychomycosis in Brazil.

Humans , Male , Female , Middle Aged , Aged , Trichosporon/isolation & purification , Trichosporon/pathogenicity , Onychomycosis/microbiology , Onychomycosis/epidemiology , Brazil/epidemiology , Colony Count, Microbial , Prevalence , Retrospective Studies , Foot Dermatoses/microbiology , Hand Dermatoses/microbiology
Braz. j. microbiol ; 46(3): 799-805, July-Sept. 2015. tab
Article in English | LILACS | ID: lil-755823


Dermatophytes are keratinophilic fungi that infect keratinized tissues causing diseases known as dermatophytoses. Dermatophytes are classified in three genera, Epidermophyton, Microsporum, and Trichophyton. This investigation was performed to study the prevalence of dermatomycosis among 640 patients being evaluated at the dermatology clinics at Kasr elainy, El-Husein and Said Galal hospitals in Cairo and Giza between January 2005 and December 2006. The patients were checked for various diseases. Tinea capitis was the most common clinical disease followed by tinea pedis and tinea corporis. Tinea cruris and tinea unguium were the least in occurrence. Tinea versicolor also was detected. The most susceptible persons were children below 10 years followed by those aged 31–40 years. Unicellular yeast was the most common etiological agent and T. tonsuranswas the second most frequent causative agent followed by M. canis.


Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Young Adult , Arthrodermataceae/isolation & purification , Onychomycosis/epidemiology , Tinea Capitis/epidemiology , Tinea Pedis/epidemiology , Tinea Versicolor/epidemiology , Egypt/epidemiology , Hospitals , Hair/microbiology , Keratins/metabolism , Nails/microbiology , Onychomycosis/microbiology , Skin/microbiology , Tinea Capitis/microbiology , Tinea Pedis/microbiology , Tinea Versicolor/microbiology
Indian J Dermatol Venereol Leprol ; 2015 Jul-Aug; 81(4): 363-369
Article in English | IMSEAR | ID: sea-160055


Introduction: Dermatophytes are the most frequently implicated agents in toenail onychomycosis and oral terbinafi ne has shown the best cure rates in this condition. The pharmacokinetics of terbinafi ne favors its effi cacy in pulse dosing. Objectives: To compare the effi cacy of terbinafi ne in continuous and pulse dosing schedules in the treatment of toenail dermatophytosis. Methods: Seventy-six patients of potassium hydroxide (KOH) and culture positive dermatophyte toenail onychomycosis were randomly allocated to two treatment groups receiving either continuous terbinafi ne 250 mg daily for 12 weeks or 3 pulses of terbinafi ne (each of 500mg daily for a week) repeated every 4 weeks. Patients were followed up at 4, 8 and12 weeks during treatment and post-treatment at 24 weeks. At each visit, a KOH mount and culture were performed. In each patient, improvement in a target nail was assessed using a clinical score; total scores for all nails and global assessments by physician and patient were also recorded. Mycological, clinical and complete cure rates, clinical effectivity and treatment failure rates were then compared. Results: The declines in target nail and total scores from baseline were signifi cant at each follow-up visit in both the treatment groups. However, the inter-group difference was statistically insignifi cant. The same was true for global assessment indices, clinical effectivity as well as clinical, mycological, and complete cure rates. Limitations: The short follow-up in our study may have led to lower cure rates being recorded. Conclusion: Terbinafi ne in pulse dosing is as effective as continuous dosing in the treatment of dermatophyte toenail onychomycosis.

Arthrodermataceae/drug effects , Double-Blind Method , Humans , Naphthalenes/administration & dosage , Nails/microbiology , Onychomycosis/drug therapy , Onychomycosis/epidemiology , Pulse Therapy, Drug/methods , Tinea/drug therapy , Tinea/epidemiology , Toes/microbiology
An. bras. dermatol ; 90(3): 334-337, May-Jun/2015. tab, graf
Article in English | LILACS | ID: lil-749656


Abstract BACKGROUND: Onychomycosis are caused by dermatophytes and Candida, but rarely by non- dermatophyte molds. These opportunistic agents are filamentous fungi found as soil and plant pathogens. OBJECTIVES: To determine the frequency of opportunistic molds in onychomycosis. METHODS: A retrospective analysis of 4,220 cases with onychomycosis, diagnosed in a 39-month period at the Institute of Dermatology and Skin surgery "Prof. Dr. Fernando A. Cordero C." in Guatemala City, and confirmed with a positive KOH test and culture. RESULTS: 32 cases (0.76%) of onychomycosis caused by opportunistic molds were confirmed. The most affected age group ranged from 41 to 65 years (15 patients, 46.9%) and females were more commonly affected (21 cases, 65.6%) than males. Lateral and distal subungual onychomycosis (OSD-L) was detected in 20 cases (62.5%). The microscopic examination with KOH showed filaments in 19 cases (59.4%), dermatophytoma in 9 cases (28.1%), spores in 2 cases (6.25%), and filaments and spores in 2 cases (6.25%). Etiologic agents: Aspergillus sp., 11 cases (34.4%); Scopulariopsis brevicaulis, 8 cases (25.0%); Cladosporium sp., 3 cases (9.4%); Acremonium sp., 2 cases (6.25%); Paecilomyces sp., 2 cases (6.25%); Tritirachium oryzae, 2 cases (6.25%); Fusarium sp., Phialophora sp., Rhizopus sp. and Alternaria alternate, 1 case (3.1%) each. CONCLUSIONS: We found onychomycosis by opportunistic molds in 0.76% of the cases and DLSO was present in 62.5%. The most frequent isolated etiological agents were: Aspergillus sp. and Scopulariopsis brevicaulis. .

Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Young Adult , Fungi , Onychomycosis/microbiology , Opportunistic Infections/microbiology , Age Distribution , Brazil/epidemiology , Fungi/isolation & purification , Onychomycosis/epidemiology , Opportunistic Infections/epidemiology , Retrospective Studies , Sex Distribution
Braz. j. microbiol ; 46(2): 485-492, Apr-Jun/2015. tab, graf
Article in English | LILACS | ID: lil-749739


Onychomychosis, a nail fungus infection is the most frequent nail ailment, constituting about half of all nail disorders. It can be caused by dermatophytes, non-dermatophytes, yeasts and Prothoteca spp. Methods include 5407 samples of patients with suspected onychomycosis, studied from January 2002 to December 2006, by direct mycological examination and fungi culture. The diagnosis of onychomycosis was confirmed in samples from 3822 direct mycological and/or culture positive. The diagnosis was established by culture for fungi. Among the 1.428 identified agents, the dermatophytes were responsible for 68.6% (N = 980) of cases, followed by yeasts with 27.6% (N = 394), non-dermatophytes fungi with 2.2% (N = 31), Prothoteca spp with 0.1% (N = 2), and associations with 1.5% (N = 22). Females were more affected, with 66% (N = 2527) of cases, and the most affected age group ranged from 31 to 60 years of age (median 47 years). Fungal microbiota is often changed in the world, both quantitatively and qualitatively, and is affected by several environmental factors. Thus, the periodic review of the composition of this microbiota is important to evaluate the epidemiology and thus proportion a better therapeutic response.

Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Young Adult , Fungi/classification , Fungi/isolation & purification , Onychomycosis/epidemiology , Onychomycosis/microbiology , Age Distribution , Brazil/epidemiology , Coinfection/epidemiology , Coinfection/microbiology , Hospitals , Microbiological Techniques , Prevalence , Sex Distribution
Invest. clín ; 55(4): 311-320, dic. 2014. tab
Article in Spanish | LILACS | ID: lil-783086


Las enfermedades fúngicas superficiales que afectan la piel y sus faneras son motivo de consultas en los servicios básicos de triaje y en dermatología. Se encuentran distribuidas en Venezuela con una incidencia de 92,9%. El objetivo del presente estudio fue conocer los géneros y especies que causan dermatomicosis en pacientes residentes del estado Anzoátegui, Venezuela, en el período 2002-2012. Se estudiaron 4257 pacientes con edades entre 7 meses y 79 años. La prevalencia general fue de 30,9%. Las más frecuentes fueron las dermatofitosis (44,7%). M. canis produjo 148 casos de tiña de la cabeza. Tres agentes dermatofiticos representaron el 95% de todos los casos, con predominio significativo de T. mentagrophytes representado por un 50%. La candidosis se presentó en 28,4%. C. albicans, y el complejo C. parapsilosis, fueron responsables del 80% de los casos. Otras especies identificadas fueron C. tropicalis (n = 41; 11,0%), C. glabrata (n = 10; 2,7%), C. guilliermondii (n = 6; 1,6%), C. krusei (n = 4; 1,1%). Pitiriasis versicolor se presentó en (22,4%), y en menor frecuencia la onicomicosis por mohos no dermatofitos, dominando Fusarium oxysporum (n = 34; 65,4%), Aspergillus terreus (n = 16; 30,8%) y Scytalidium dimidiatum (2; 3,8%). Raros casos de onicomicosis por Trichosporon (0,5%) y un caso de tinea negra. Estos resultados revelan una alta frecuencia de las micosis superficiales con predominio de las dermatofitosis indicando la existencia de un problema de salud pública.

Superficial fungal diseases that affect the skin and its appendages are frequently seen in basic triage and in dermatology services. These diseases are distributed in Venezuela with an incidence of 92.9%. The aim of this study was to determine the genera and species that cause dermatomycoses in residents of Anzoátegui state, Venezuela, during the period 2002-2012. A total of 4257 patients with a presumptive diagnosis of superficial mycoses were studied, with ages from 7 months to 79 years. The overall prevalence was 30.9%. The most frequent were dermatophytosis (44.7%). M. canis produced 148 cases of tinea capitis. Three dermatophytic agents represented 95% of all cases, with a significant predominance of T. mentagrophytes with 50%. Candidosis occurred in 28.4%. C. albicans, and the C. parapsilosis complex, were responsible for 80% of the cases. The other species identified were C. tropicalis (n = 41, 11.0%), C. glabrata (n = 10, 2.7%), C. guilliermondii (n = 6, 1.6%), C. krusei (n = 4, 1.1%). Pityriasis versicolor occurred in 22.4% of the cases studied, and less frequently were present onychomycosis produced by a non dermatophytic mold: Fusarium oxysporum (n = 34, 65.4%), Aspergillus terreus (n=16, 30.8%) and Scytalidium dimidiatum (n=2; 3.8%). Rare cases of Trichosporon onychomycosis (0.5%) and one case of black tinea were also found. Health education in the population is recommended to promote measures to prevent transmission of these fungi and prevent the spread of this silent public health problem.

Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Young Adult , Dermatomycoses/epidemiology , Candidiasis, Cutaneous/epidemiology , Candidiasis, Cutaneous/microbiology , Dermatomycoses/microbiology , Onychomycosis/epidemiology , Onychomycosis/microbiology , Prevalence , Retrospective Studies , Rural Population , Tinea/epidemiology , Tinea/microbiology , Urban Population , Venezuela/epidemiology
Article in English | IMSEAR | ID: sea-157676


Onychomycosis is a common nail infection caused by dermatophytes, yeast or other non-dermatophyte molds and have been known to be associated with significant physical and psychological morbidity. This study was performed to determine the prevalence and the etiologic agents of onychomycosis in patients attending RIMS, Imphal, Manipur for a period of two years (January 2010 to December 2012). Nail samples of 347 clinically suspected cases of onycomycosis attending dermatology OPD RIMS, Manipur were collected and were subjected to potassium hydroxide (KOH) mounts for direct microscopy and fungal culture on Sabouraud’s dextrose agar (SDA). The male female ratio of the participants was 1:1.81 (165 male and 302 female). Out of 467, 399 (85.44.%) were positive by culture and KOH mount. Young adults in the age group of 21-30 years were commonly affected. In female patients finger nail infection was more common than toe nail infection. Both toe and finger nails involvement were noticed in nine patients of which two were male and seven were female. The most frequently isolated fungus was dermatophytes, in 107 (40.38%) patients followed by Aspergillus spp in 101 (38.11%) and Candida spp in 17 (6.4%). This study demonstrated that dermatophytes, as well as moulds especially Aspergillus spp are commonly isolated from onychomycosis patients in our region.

Adult , Agar , Culture Media , Culture Techniques , Female , Fungi/growth & development , Humans , Hydroxides/diagnosis , India/epidemiology , Male , Mycoses/epidemiology , Mycoses/etiology , Nails/microbiology , Onychomycosis/epidemiology , Onychomycosis/etiology , Onychomycosis/microbiology , Potassium Compounds/diagnosis , Prevalence , Young Adult
Braz. j. infect. dis ; 18(2): 181-186, Mar-Apr/2014. tab, graf
Article in English | LILACS | ID: lil-709425


BACKGROUND: Dermatophytes are the main causative agent of all onychomycosis, but genus Microsporum is infrequent and the risk of acquiring the infection is often associated with exposure to risk factors. OBJECTIVES: To describe clinical characteristics of onychomycosis due to Microsporum onychomycosis in an urban population. METHODS: This was a retrospective analysis of the epidemiological and clinical features of 18Microsporum onychomycosis cases of a total of 4220 of onychomycosis cases diagnosed between May 2008 and September 2011 at the tertiary referral center for mycology in Guatemala. RESULTS: Eighteen cases of Microsporum onychomycosis (M. canis, n=10; M. gypseum, n=7; M. nanum, n=1) were identified (prevalence=0.43%). Infection was limited to nails only and disease duration ranged from 1 month to 20 years (mean=6.55 years). The toenails were affected in all cases except for a single M. gypseum case of fingernail. The most common clinical presentation was distal lateral subungual onychomycosis (12/18) followed by total dystrophic onychomycosis (5/18), and superficial white onychomycosis (1/18). M. gypseumpresented in 6 cases as distal lateral subungual onychomycosis and in 1 case like total dystrophic onychomycosis. Five cases (27.78%) were associated with hypertension, diabetes, and psoriasis. Treatment with terbinafine or itraconazole was effective. Two cases of M. canisdistal lateral subungual onychomycosis responded to photodynamic therapy. CONCLUSION: This is the largest reported series of Microsporum onychomycosis and demonstrates such a disease in an urban population. In 27.78% of the cases risk factors for infection were associated to comorbid states. We also report the first 2 cases of successfully treated M. canis onychomycosis with photodynamic therapy and a rare case of M. canis associated dermatophytoma. .

Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Young Adult , Foot Dermatoses , Microsporum , Onychomycosis , Antifungal Agents/therapeutic use , Fluconazole/therapeutic use , Foot Dermatoses/drug therapy , Foot Dermatoses/epidemiology , Foot Dermatoses/microbiology , Guatemala/epidemiology , Itraconazole/therapeutic use , Naphthalenes/therapeutic use , Onychomycosis/drug therapy , Onychomycosis/epidemiology , Onychomycosis/microbiology , Prevalence , Retrospective Studies , Risk Factors , Urban Population
Rev. Soc. Bras. Med. Trop ; 47(1): 74-78, Jan-Feb/2014. tab
Article in English | LILACS | ID: lil-703169


Introduction: There are more than 300,000 extractors using the babaçu coconut as a source of income in the States of Maranhão, Pará, Tocantins and Piauí, and this activity is associated with fungal infections. The objective of this study was to examine the occurrence of emergent fungi in the conjunctiva, nails and surface and subcutaneous injuries of female coconut breakers in Esperantinópolis, Maranhão. Additionally, soil samples and palm structures were collected. Methods: The obtained samples were cultured in Petri dishes containing potato-dextrose-agar and chloramphenicol. The etiological agent was confirmed by a direct mycological exam and growth in culture. Results: In total, 150 domiciles were visited, and samples were collected from 80 patients. From the ground, the most frequently isolated fungus was Aspergillus niger (53. 8%). the most frequently detected fungus in babaçu coconut was Aspergillus niger (66.7%). Conjunctival fungal growth occurred in 76.3% of the women. The ocular fungal microbiota consisted of filamentous fungi (80.6%), and yeasts were present in 19.4% of cases. Onychomycosis was diagnosed in 44% (11/25) of the women. Conclusions: The identification of the genera Neosartorya, Rhizopus and Curvularia in onychomycoses shows that emergent filamentous fungi can be isolated. Aspergillus sp., Penicillium sp. and Scedosporium sp. were the predominant genera found in the babaçu coconut. From ocular conjunctiva, Candida spp. were the most prevalent species isolated, and Fusarium sp. was present only in one woman. The nearly permanent exposure of coconut breakers to the external environment and to the soil is most likely the reason for the existence of a mycotic flora and fungal infections, varying according to the individual's practices and occupation. .

Female , Humans , Agricultural Workers' Diseases/microbiology , Cocos/microbiology , Eye Infections, Fungal/microbiology , Fungi/isolation & purification , Mycoses/microbiology , Onychomycosis/microbiology , Agricultural Workers' Diseases/epidemiology , Brazil/epidemiology , Epidemiologic Studies , Eye Infections, Fungal/epidemiology , Fungi/classification , Mycoses/epidemiology , Onychomycosis/epidemiology , Risk Factors
Rev. chil. dermatol ; 30(3): 271-274, 2014. tab
Article in Spanish | LILACS | ID: biblio-835959


Introducción: la onicomicosis en niños y adolescentes ha presentadoaumento en la prevalencia, siendo Trichophyton rubrum detectadocon mayor frecuencia en uñas de pies y Candida en uñas de manos.Hasta la fecha no existen estudios etiológicos de onicomicosis enpoblación pediátrica chilena. Objetivo: Determinar los agentes fúngicospresentes en uñas enfermas con sospecha de onicomicosis enniños y adolescentes estudiados en el Hospital Clínico Universidadde Chile. Pacientes y método: Estudio retrospectivo que analizó losregistros micológicos de muestras de uñas de pacientes entre 0 y 18años, estudiados en el Laboratorio del Departamento de Dermatologíadel Hospital Clínico Universidad de Chile desde Enero hastaSeptiembre 2012. Todas las muestras fueron analizadas con microscopíadirecta mediante KOH 10% y cultivo de hongos en agar Sabouraud. Resultados: Se analizaron los registros de 100 pacientes, 58 de sexo masculino, con sospecha de onicomicosis. Del registro demuestras de uñas de pies (n=84), 41 presentaron micológico directopositivo para hongos filamentosos o levaduras, de los cuales 13 tuvieroncultivos de hongos positivo para T. rubrum y 2 para Candidasp. Del registro de muestras de uñas de manos (n=16), 10 tuvieronmicológico directo positivo para hongos filamentosos o levaduras, delos cuales se encontró positivo un cultivo de hongos para Candidasp...

Introduction: onychomycosis in children and adolescents haspresented increased prevalence. Trichophyton rubrum is detectedmore often in toenails and Candida sp in fingernails. Todate there are no studies of onychomycosis causative in Chileanpediatric population. Objective: To determine the fungalagents in diseased nails with suspected onychomycosis in childrenand adolescents studied at the University of Chile Clinical Hospital. Patients and method: Retrospective study analyzingmycological records of nail samples of patients between 0 and18 years old, studied at the Laboratory of the Department of Dermatology, Clinical Hospital University of Chile from Januaryto September 2012. All samples were analyzed by direct microscopywith KOH 10% and fungal culture on Sabouraud agar. Results: The records of 100 patients, 58 males, with suspectedonychomycosis were analyzed. Records toenail (n = 84),41 were positive in direct mycological test for filamentous fungior yeasts, of which 13 were positive fungal cultures for T. rubrumand 2 for Candida sp. The fingernails records (n = 16),10 were mycological direct test positive for filamentous fungior yeast, of which one fungal out culture for Candida sp waspositive...

Humans , Male , Adolescent , Female , Infant, Newborn , Infant , Child, Preschool , Onychomycosis/epidemiology , Onychomycosis/microbiology , Chile , Retrospective Studies , Sex Distribution
Indian J Dermatol Venereol Leprol ; 2013 Nov-Dec; 79(6): 777-782
Article in English | IMSEAR | ID: sea-154678


Background: Onychomycosis is a world-wide public health concern in children, requiring epidemiological data for different regions for control and prevention. Aim: The aim of this study was to evaluate the predominant pathogens and risk factors for onychomycosis in school children living in Kayseri, Turkey. Methods: This study included 8122 school children, aged 5-16 years, living in the rural and urban areas around Kayseri. Onychomycosis was clinically classifi ed as distal and lateral subungual (DLSO), proximal subungual, superfi cial white, endonyx and totally dystrophic onychomycosis. Nail samples from children with clinically diagnosed onychomycosis were collected, examined by direct microscopy and inoculated for culture study. The demographic features and possible risk factors were recorded and assessed by logistic regression models. Results: We clinically diagnosed onychomycosis in 152 out of 8,122 (0.18%) school children. DLSO was the most frequent clinical diagnosis (120/152, 78.9%). Culture-positive onychomycosis was detected in 27/152 (17.7%) children. The prevalence of culture-positive onychomycosis was determined as 0.33%. All culture-positive samples were only from toenails. The onychomycosis causative agents were dermatophytes in 17/27 cases (62.9%), including Trichophyton rubrum 12 (44.4%), Trichophyton mentagrophytes 1 (3.7%), Trichophyton tonsurans 1 (3.7%) and Trichophyton spp. 3 (11.1%) and yeasts in 10/27 cases (37.1%), including Candida glabrata 4 (14.8%), Candida parapsilosis 1 (3.7%), Trichosporon 2 (7.4%) and Rhodotorula 3 (11.1%). Age, father’s occupation, number of siblings and rooms were statistically associated with the frequency of onychomycosis. Conclusions: Although to be prevalence of onychomycosis in school children in central Anatolia of Turkey seems very low degree, pediatric onychomycosis is a growing public health concern all over the world. Children having more siblings or unemployed fathers and children living in small house as well as older children should be examined carefully for onychomycosis.

Adolescent , Candida albicans/isolation & purification , Child , Child, Preschool , Cross-Sectional Studies , Female , Foot Dermatoses/diagnosis , Foot Dermatoses/epidemiology , Humans , Male , Onychomycosis/diagnosis , Onychomycosis/epidemiology , Prevalence , Risk Factors , Rural Population/trends , Students , Turkey/epidemiology , Urban Population/trends
An. bras. dermatol ; 88(3): 377-380, jun. 2013.
Article in English | LILACS | ID: lil-676227


BACKGROUND: Superficial fungal infections are caused by dermatophytes, yeasts or filamentous fungi. They are correlated to the etiologic agent, the level of integrity of the host immune response, the site of the lesion and also the injured tissue. OBJECTIVE: The purpose of this study is to isolate and to identify onychomycosis agents in institutionalized elderly (60 years old +). METHODS: The identification of the fungi relied upon the combined results of mycological examination, culture isolation and micro cultures observation under light microscopy from nail and interdigital scales, which were collected from 35 elderly with a clinical suspicion of onychomycosis and a control group (9 elderly with healthy interdigital space and nails). Both groups were institutionalized in two nursing homes in Sao Bernardo do Campo, SP, Brazil. RESULTS: The nail scrapings showed 51.40% positivity. Of these, dermatophytes were found in 44.40% isolates, 27.78% identified as Trichophyton rubrum and 5.56% each as Trichophyton tonsurans, Trichophyton mentagrophytes and Microsporum gypseum. The second more conspicuous group showed 38.89% yeasts: 16.67% Candida guilliermondii, 11.11% Candida parapsilosis, 5.56% Candida glabrata, and 5.56% Trichosporon asahii. A third group displayed 16.70% filamentous fungi, like Fusarium sp, Aspergillus sp and Neoscytalidium sp (5.56% each). The interdigital scrapings presented a positivity rate of 14.29%. The agents were coincident with the fungi that caused the onychomycosis. In the control group, Candida guilliermondii was found at interdigital space in one person. CONCLUSION: Employing a combination of those identification methods, we found no difference between the etiology of the institutionalized elderly onychomycosis from that reported in the literature for the general population. .

FUNDAMENTOS: As infecções fúngicas superficiais se correlacionam com o agente etiológico, a resposta imune do hospedeiro, o local da lesão e o tecido lesado, sendo causadas por dermatófitos, leveduras ou fungos filamentosos. OBJETIVO: O objetivo é isolar e identificar os agentes das onicomicoses em idosos institucionalizados. MÉTODO: A identificação dos fungos baseou-se nos resultados combinados do exame micológico, isolamento em cultura e da observação de microculturas sob microscopia de luz, do material subungueal e escamas interdigitais, coletado de 35 idosos com suspeita clínica de onicomicose e de um grupo controle (9 idosos com espaço interdigital e unhas saudáveis). Ambos os grupos eram institucionalizados em duas casas de assistência em São Bernardo do Campo, SP, Brasil. RESULTADOS: As unhas raspadas apresentaram 51,40% de positividade. Os dermatófitos foram encontrados em 44,40% de isolados, sendo 27,78% identificados como Trichophyton rubrum e 5,56%, cada, como Trichophyton tonsurans, Trichophyton mentagrophytes e Microsporum gypseum. O segundo grupo mais frequente (38,89%) foi o de leveduras, identificadas como 16,67% Candida guilliermondii, 11,11% Candida parapsilosis, 5,56% Candida glabrata e 5,56% Trichosporon asahii. Um terceiro grupo exibia 16,70% fungos filamentosos, como Fusarium sp, Aspergillus sp e Neoscytalidium (5,56% de cada). Os raspados interdigitais exibiram positividade de 14,29%. Os agentes foram coincidentes com os fungos que causaram a onicomicose. No grupo controle, a Candida guilliermondii foi identificada no espaço interdigital em apenas uma pessoa. CONCLUSÃO: Empregando-se a combinação destes métodos de identificação, não houve diferença entre a etiologia da onicomicose ...

Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Foot Dermatoses/microbiology , Institutionalization , Mitosporic Fungi/isolation & purification , Onychomycosis/microbiology , Brazil/epidemiology , Foot Dermatoses/epidemiology , Homes for the Aged/statistics & numerical data , Onychomycosis/epidemiology , Sex Factors
An. bras. dermatol ; 88(supl.1): 3-11, fev. 2013.
Article in English | LILACS | ID: lil-667949


BACKGROUND: Onychomycosis is a type of fungal infection that accounts for over 50% of all onycopathies. Some authors consider superficial mycosis the most difficult to be treated. Very few studies have been carried out in order to assess the epidemiology of onychomycosis in Brazil. OBJECTIVE: To describe the epidemiological profile of onychomycosis in Brazilian dermatology offices and to assess the etiology of the disease, how often mycosis exams are requested, and the treatment adopted. METHODS: A descriptive, observational study was carried out between May and July, 2010. Thirty-eight dermatologists from different Brazilian regions participated in the study, and 7,852 patients with any skin diseases who had all of their nails examined were included in the study. RESULTS: Of the 7,852 patients, 28.3% were clinically diagnosed as having onychomycosis. Women over 45 years old who practiced exercises or with a personal history of the disease showed greater likelihood of having onychomycosis. The disease was most seen in the feet, and the majority of cases involved the hallux. On the hands, the index finger was the most affected. Mycosis exams were not requested for all clinically suspected cases. When exams were done, results showed that the most common fungus was Trichophyton rubrum. The most common clinical lesion was distal-lateral. The most prescribed topical treatments were amorolfine and ciclopirox olamine, while systemic treatments included fluconazole and terbinafine. CONCLUSION: This study was important to describe the epidemiological behavior of onychomycosis in Brazilian ...

BACKGROUND: Fundamentos: As onicomicoses são infecções fúngicas que representam mais de 50% de todas onicopatias e são consideradas por alguns autores a micose superficial de mais difícil tratamento. Poucos estudos foram feitos para investigar a epidemiologia da onicomicose no Brasil. OBJETIVO: Descrever perfil epidemiológico da onicomicose nos consultórios brasileiros de dermatologia. Também observar a etiologia, a freqüência da solicitação do exame micológico e a terapia empregada. MÉTODOS: Foi realizado um estudo descritivo e observacional no período de Maio a Julho de 2010. Participaram 38 dermatologistas de diferentes regiões do Brasil e foram incluídos 7852 pacientes. RESULTADOS: Dos 7852 pacientes, 28.3% apresentaram diagnóstico de onicomicose. Mulheres, maiores de 45 anos, praticantes de esportes, ou com histórico pessoal da doença, apresentaram chance maior de adquirir onicomicose. A doença foi mais frequente nos pés, sendo o hálux, o dedo mais acometido. Nas mãos, o primeiro dedo foi o mais atingido. Exame micológico não foi solicitado para todos os casos. Quando realizado, o fungo mais freqüente foi o Trichophyton rubrum. A lesão clinica mais comum foi a distal-lateral. Os tratamentos tópicos mais prescritos foram amorolfina e ciclopirox olamina, enquanto os sistêmicos foram o fluconazol e a terbinafina. CONCLUSÃO: Este estudo foi de fundamental importância para descrever o comportamento epidemiológico ...

Adolescent , Adult , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Young Adult , Dermatology/statistics & numerical data , Foot Dermatoses/epidemiology , Hand Dermatoses/epidemiology , Onychomycosis/epidemiology , Onychomycosis/therapy , Brazil/epidemiology , Comorbidity , Exercise/physiology , Foot Dermatoses/diagnosis , Foot Dermatoses/microbiology , Foot Dermatoses/therapy , Hand Dermatoses/diagnosis , Hand Dermatoses/microbiology , Hand Dermatoses/therapy , Onychomycosis/diagnosis , Prevalence , Risk Factors
Rev. argent. microbiol ; 44(1): 0-0, mar. 2012. tab
Article in Spanish | LILACS | ID: lil-639713


Desde marzo de 2007 hasta marzo de 2011 se estudiaron prospectivamente 414 pacientes con onicodistrofias en un laboratorio privado de Esquel. La prevalencia de onicomicosis de pie fue del 78 %; la de mano, del 58 %. Los principales agentes etiológicos fueron Trichophyton rubrum, Candida spp. y Trichophyton mentagrophytes. El desarrollo de dermatofitos prevaleció en las onicopatías de pie y el de Candida spp. en las de uñas de mano (ambos, p < 0,05). En las onicomicosis candidiásicas predominaron especies diferentes a Candida albicans. Las onicomicosis fueron más frecuentes en los hombres que en las mujeres. A su vez, en los hombres hubo más aislamientos de T. rubrum en pies (p < 0,05) y mayor proporción de exámenes directos (ED) y cultivos positivos (ambos, p < 0,05). La correlación entre los resultados del ED y del cultivo fue del 68 %. El rédito de ambos métodos se asoció a un mayor tamaño de la lesión ungueal. El ED fue más efectivo en onicodistrofias que superaban los 5 años de evolución. La positividad del cultivo fue independiente de la cronicidad de la onicodistrofia.

Since March 2007 to March 2011, 414 patients with onychopathies were prospectively analyzed. Prevalence of the toenail and fingernail mycoses was 78 % and 58 %, respectively. The major etiological agents were Trichophyton rubrum, Candida spp. and Trichophyton mentagrophytes. Dermatophytes were more frequently cultured from toenails, whereas Candida spp. from fingernails (both, p < 0.05). In candidal onychomycosis, species different from C. albicans were prevalent. A higher prevalence of toenail and fingernail mycoses, a predominance of T. rubrum in toenails (p < 0.05), and greater positivity in the direct examination (DE) and in culture (both, p < 0.05) were more frequently observed in men than in women. The correlation between DE and culture was 68 %. DE and culture yields were associated with a greater size lesion. DE was more effective in onycodystrophies with duration of more than 5 years. Culture positivity was independent of nail affection chronicity.

Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Young Adult , Mycology/methods , Onychomycosis , Argentina/epidemiology , Chronic Disease , Candida/growth & development , Candida/isolation & purification , Candidiasis, Cutaneous/diagnosis , Candidiasis, Cutaneous/epidemiology , Candidiasis, Cutaneous/microbiology , Fingers/microbiology , Onychomycosis/diagnosis , Onychomycosis/epidemiology , Onychomycosis/microbiology , Physical Examination , Prevalence , Prospective Studies , Tinea Capitis/diagnosis , Tinea Capitis/epidemiology , Tinea Capitis/microbiology , Toes/microbiology , Trichophyton/growth & development , Trichophyton/isolation & purification
Rev. chil. dermatol ; 28(2): 146-151, 2012. graf
Article in Spanish | LILACS | ID: lil-718974


Introducción: Las patologías cutáneas son una frecuente razón de consulta en prisiones. Objetivo: El objetivo de este estudio fue analizar el perfil de patologías cutáneas en un centro penal chileno. Metodología: Se estudiaron 89 internos con cinco o más años de reclusión seleccionados al azar. La muestra corresponde al 36 por ciento de la población de un centro penal ubicado en la IV Región de Coquimbo. Se registraron los siguientes datos: nivel educacional, orientación sexual, antecedentes de uso de drogas, hábito de fumar, ingesta de alcohol, fenotipo cutáneo, actividad laboral en prisión y años de reclusión. Resultados: La edad promedio de los reclusos fue de 34,8 años, con un promedio de tiempo de reclusión de 7 años. Un 85,4 por ciento de los internos examinados presentó alguna patología cutánea, dentro de las cuales las más frecuentes fueron pitiriasis versicolor (22,4 por ciento), onicomicosis (18 por ciento) y tinea pedis (14,6 por ciento). No se encontraron diferencias significativas entre el perfil patologías cutáneas y prisioneros con más o menos de 10 años de reclusión; hábito de fumar; orientación sexual; ingesta alcohólica; fenotipo de piel; actividad laboral dentro de la prisión y consumo de drogas ilícitas. Discusión: Este es el primer estudio acerca del perfil de patologías dermatológicas en un recinto penitenciario chileno, cuyos resultados confirman reportes previos descritos en otros países, donde las patologías cutáneas más frecuentes encontradas corresponden a patologías de origen micótico, posiblemente explicado por el estrés, condiciones sanitarias, poco acceso a la atención de salud, actividad física, entre otras. A diferencia de otros estudios, en el nuestro no se encontró escabiosis ni pediculosis.

Introduction: The skin diseases are a frequent reason for consultation in prisons. Objective: The aim of this study was to analyze the profile of skin disorders in a detention center in Chile. We studied 89 inmates with five or more years of imprisonment randomly selected. Results: The sample corresponds to 36 percent of the population of a penal facility located in the IV Region of Coquimbo. The following data were recorded: educational level, sexual orientation, drug use, smoking, alcohol intake, skin phenotype, work activity in prison and years of imprisonment. The average age of inmates was 34.8 years, with an average time of seven years imprisonment. 85.4 percent of inmates analyzed, showed some skin disease, the most frequent were pityriasis versicolor (22.4 percent), onychomycosis (18 percent) and tinea pedis (14.6 percent). No significant differences were found between the profile of skin diseases and the following: prisoners with more and less than 10 years of imprisonment, smoking habit , sexual orientation, alcohol intake, skin phenotype; work activity within the prison and use of illicit drugs. Discussion: This is the first study on the profile of dermatological diseases in a Chilean prison, whose results confirm previous reports described in other countries, where the most common skin diseases found correspond to diseases of fungal origin, possibly explained by stress, health conditions, poor access to health care, physical activity, among others. Unlike other studies, in our investigation, we did not observed scabies or lice.

Humans , Male , Adult , Middle Aged , Skin Diseases/epidemiology , Prisoners , Alcohol Drinking , Chile , Onychomycosis/epidemiology , Prisons , Sexuality , Smoking , Tinea Versicolor/epidemiology , Tinea Pedis/epidemiology
An. bras. dermatol ; 86(4): 689-693, jul.-ago. 2011. ilus
Article in Portuguese | LILACS | ID: lil-600610


FUNDAMENTOS: O Scytalidium spp. é fungo filamentoso, saprobio do solo e plantas, considerado, atualmente, patógeno primário das unhas. A prevalência das infecções ungueais causadas por este fungo vem aumentando nas últimas décadas, embora ainda sejam poucos os trabalhos publicados sobre sua epidemiologia. OBJETIVO: Estudo clínico-epidemiológico dos pacientes portadores de onicomicose por Scytalidium spp. em um hospital universitário do Rio de Janeiro. MÉTODOS: Foram avaliados os dados clínico-epidemiológicos de 30 pacientes com onicomicose por Scytalidium spp. por meio do estudo observacional de 1.295 pacientes que se submeteram a exame micológico ungueal no período de 16 meses. RESULTADOS: A maioria dos pacientes era do sexo feminino (66,6 por cento), a média de idade foi de 56,7 anos e 63,3 por cento eram não-brancos. O nível de escolaridade em 53,3 por cento dos pacientes era o ensino fundamental e a renda familiar predominante foi de 3 a 5 salários mínimos em 36,6 por cento dos entrevistados. Em 90 por cento dos casos, as unhas dos pododáctilos foram acometidas, sendo a alteração clínica mais comum a onicólise (18 pacientes) e em 66,6 por cento dos casos observou-se melanoníquia. O tempo de evolução da doença foi maior do que cinco anos em 43,3 por cento dos casos. Dezenove pacientes (63,3 por cento) já haviam realizado tratamento medicamentoso para o quadro atual. CONCLUSÕES: Os dados mostram que a infecção ungueal pelo Scytalidium spp. é crônica, mais comum no sexo feminino (2:1) e atinge indivíduos adultos. Clinicamente, é semelhante às dermatofitoses. A prevalência na amostra estudada foi de 4,86 por cento e correspondeu a 26,92 por cento dos exames positivos.

BACKGROUND: Scytalidium sp. is a filamentous (thread-like), saprobic fungus which affects soil and plants. It is currently considered a primary pathogen of the nail. The prevalence of nail infections caused by this fungus has been increasing in recent decades, although few published studies have been done on its epidemiology. OBJECTIVE: To study clinico-epidemiological data referring to patients with onychomycosis caused by Scytalidium spp. at a University Hospital in Rio de Janeiro. METHODS: We evaluated the clinical and epidemiological data of 30 patients with onychomycosis by Scytalidium sp. through an observational study of 1295 patients who underwent mycological nail tests over a period of 16 months. RESULTS: The majority of the patients were female (66.6 percent), with an average age of 56.7 years. 63.3 percent of them were nonwhite. 53.3 percent of the patients had attended elementary school and 36.6 percent referred a family income of 3 to 5 minimum wages. In 90 percent of cases, the toenails were affected, primarily with onycholysis (18 patients), and in 66 percent of the cases melanonychia was observed. In 43.3 percent of cases the disease had progressed for more than 5 years. 19 patients (63.3 percent) had undergone some medical treatment for their current condition. CONCLUSIONS: Our data show that nail infection by Scytalidium sp. is chronic, affecting adults, particularly females (2:1). Clinically the disease resembles dermatophytosis. Prevalence of the disease in our sample was 4.86 percent, accounting for 26.92 percent of the positive tests.

Adult , Female , Humans , Male , Middle Aged , Ascomycota/isolation & purification , Foot Dermatoses/microbiology , Hand Dermatoses/microbiology , Hospitals, University/statistics & numerical data , Onychomycosis/microbiology , Brazil/epidemiology , Foot Dermatoses/diagnosis , Foot Dermatoses/epidemiology , Hand Dermatoses/diagnosis , Hand Dermatoses/epidemiology , Onychomycosis/diagnosis , Onychomycosis/epidemiology , Prevalence , Socioeconomic Factors
An. bras. dermatol ; 85(6): 805-810, nov.-dez. 2010. ilus, graf
Article in Portuguese | LILACS | ID: lil-573618


FUNDAMENTO: As dermatomicoses causadas por fungos filamentosos não dermatófitos são infecções raras, exceto as onicomicoses, cuja prevalência vem crescendo nos últimos anos. Dentre esses agentes etiológicos destacam-se o Scytalidium dimidiatum e o S. hyalinum, fungos emergentes responsáveis por micoses em unhas e pele. OBJETIVO: Investigar as características epidemiológicas das onicomicoses e micoses de outras localizações causadas pelos fungos do gênero Scytalidium, utilizando-se como parâmetros sexo, idade e localizações das lesões. MÉTODOS: Avaliaram-se 81 amostras com cultura positiva para o gênero em estudo, oriundas de 74 pacientes encaminhados ao Laboratório de Investigação em Dermatologia (ID) situado na cidade do Rio de Janeiro (RJ), no período de 1997 a 2006. As amostras foram submetidas a confirmação diagnóstica por exame direto e cultura. RESULTADOS: A prevalência de onicomicoses por Scytalidium spp. foi de 0,87 por cento, entre as idades de 41 e 60 anos (48,64 por cento). Em relação à localização das lesões, os pés foram mais acometidos (91,36 por cento), com predomínio do hálux esquerdo. No exame direto, as estruturas mais encontradas foram hifas hialinas; na cultura, a espécie S. dimidiatum foi a mais frequente. CONCLUSÃO: As onicomicoses por Scytalidium spp. são raras e o S. dimidiatum foi a espécie mais isolada neste laboratório no período em estudo.

BACKGROUND: Dermatomycoses caused by non-dermatophyte filamentous fungi are rare infections, except for onychomycosis, whose prevalence has increased over the past few years. Among these etiologic agents, we highlight Scytalidium dimidiatum and S. hyalinum, emergent fungi that cause mycoses that affect the nails and skin. OBJECTIVE: To investigate the characteristics of onychomycosis and other mycoses caused by the fungi Scytalidium spp, using sex, age and site of infection as parameters. METHODS: Eighty-one samples were evaluated showing positive culture for Scytalidium spp, obtained from 74 patients referred to the Laboratory of Investigation in Dermatology (ID) located in the city of Rio de Janeiro, RJ, between 1997 and 2006. The samples were submitted to diagnostic confirmation through direct exam and culture. RESULTS: The prevalence of onychomycosis caused by Scytalidium spp. was of 0,87 percent. The most prevalent age was between 41-60 years (48.64 percent). Regarding the site of infection, the feet (91.36 percent) were most affected, with predominance of the left hallux. Hyaline hyphae were the most common structures in direct examination and the species S. dimidiatum was the most frequent in culture. CONCLUSION: Onychomycosis caused by Scytalidium spp. is rare and S. dimidiatum was the most isolated species in this laboratory during the period of the study.

Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Young Adult , Ascomycota/isolation & purification , Foot Dermatoses/microbiology , Hand Dermatoses/microbiology , Onychomycosis/microbiology , Ascomycota/classification , Foot Dermatoses/diagnosis , Foot Dermatoses/epidemiology , Hand Dermatoses/diagnosis , Hand Dermatoses/epidemiology , Onychomycosis/diagnosis , Onychomycosis/epidemiology , Prevalence