Micosis en los pies: descripción clínico-epidemiológica en un centro de referencia de Bogotá, Colombia / Foot mycosis: clinical and epidemiological characterization in one referal center in Bogota, Colombia

Objetivo: Describir las características clínico-epidemiológicas de una población con diagnóstico de infección cutánea micótica en los pies confirmada por examen directo con KOH y cultivo en un centro de referencia de Bogotá, Colombia. Material y método: Estudio observacional descriptivo en el que se incluyeron todos los pacientes con lesiones en los pies que fueron atendidos en el servicio de micología entre el año 2011 y el 2016. Se analizaron las características sociodemográficas, clínicas, etiologías y el perfil de tratamiento por medio de un análisis bivariado. Resultados: Se incluyeron 305 pacientes, de los cuales el 82% residía en zona urbana de la ciudad de Bogotá. El hábito más frecuente fue bañarse descalzo, la forma clínica que predominó fue la interdigital y el 35% de los casos presentó de forma simultánea tiña del pie y onicomicosis. Los agentes etiológicos más comunes fueron los dermatofitos con el 95,2% de los casos. Discusión: La presentación clínica sugestiva de micosis, además del resultado positivo del examen directo y del cultivo, permiten hacer el diagnóstico de estas in fecciones. Las características sociodemográficas de quienes sufren este tipo de micosis en Colombia se relacionan con su contagiosidad y tendencia a la cronicidad. La intervención de tales aspectos debe hacer parte de las estrategias para su prevención.

Objective: To describe the clinical and epidemiological characteristics of the population with cutaneous mycosis in the feet confirmed by positive mycological studies diagnosed in a reference center in Bogota, Colombia. Methods: Descriptive observational study in which all patients with lesions in the feet that were treated in the mycology service between 2011 and 2016 were included. In all cases KOH examination and fungal culture were performed. The sociodemographic and clinical characteristics, etiologies and the treatment profile were assessed using a bivariate analysis. Results: A total of 305 patients were included, of which 61% were men and 82% lived in an urban area of the city of Bogota. The most common behavior was to take a barefoot bath, the most important comorbidities were venous insufficiency and psoriasis, the main clinical form was interdigital and 35% of the cases presented simultaneously tinea pedis and onychomycosis. The group of dermatophytes was the most frequently isolated (95.2%). Discussion: Clinical examination corresponding with mycosis in the feet, direct examination, and positive culture, allow the physician accurate diagnosis and guide the most appropriate treatment of these infections according to their etiology. The sociodemographic characteristics of those who suffer from this mycosis in Co lombia are related to their contagiousness and tendency to chronicity, therefore, the intervention of such aspects must be part of the strategies for their prevention.

Anti-corticosteroids combined therapy for treatment of chronic central serous chorioretinopathy / Terapia combinada de anti-corticosteroides para o tratamento da coriorretinopatia serosa central

Abstract The therapeutic impact is described with the combined use of two medications with different anti-corticosteroid actions in the clinical resolution of a patient with chronic central serous chorioretinopathy.

Resumo Descrevemos nesse artigo o impacto terapêutico do uso combinado de duas medicações anti-corticosteroides com diferentes mecanismos de ação, na resolução clínica de um paciente com coriorretinopatia serosa central crônica.

Frequency of mixed onychomycosis with total nail dystrophy in patients attended in a Guatemalan Dermatology Center / Frecuencia de onicomicosis mixta con distrofia ungueal total en pacientes atendidos en un Centro de Dermatología de Guatemala

Introduction: Onychomycosis are fungal nail infections that can be caused by dermatophytes, non-dermatophytic molds and yeasts, which are capable of breaking down keratin. Mixed onychomycosis are a controversial subject and they are the outcome of the combination of two dermatophytes, dermatophytes/nondermatophytic molds or dermatophytes/yeast. Objetives: To determine the frequency of total dystrophic onychomycosis caused by more than one etiological agent (mixed onychomycosis) in outpatients from a Dermatologic Center in Guatemala and to establish the characteristics associated with this fungal infection. Methods: Prospective observational study from August to December of 2012. Nail samples were obtained from patients with total dystrophic onychomycosis to identify the causal agents by culture in Sabouraud dextrose and Mycosel® agar. Results: 32 of 130 patients had mixed onychomycosis. 68.5% were associated to tinea pedis. The most common association was between T. rubrum + Candida, T. rubrum + M. canis and T. rubrum + opportunist fungi. Conclusions: Mixed onychomycosis represent 25% of the total dystrophic onychomycosis in Guatemala. We observed an important relationship between diabetes and the main association was T. rubrum with Candida spp.

Introducción: Las onicomicosis son infecciones fúngicas de las uñas que pueden ser causadas por dermatofitos, mohos no dermatofitos y levaduras, que son capaces de degradar la queratina. Las onicomicosis mixtas son un tema polémico y es el resultado de la combinación de dos dermatofitos, dermatofitos / mohos no dermatofitos o dermatofitos / levadura. Objetivos: Determinar la frecuencia de la onicomicosis distrófica total causada por más de un agente etiológico (onicomicosis mixta) en pacientes ambulatorios de un Centro Dermatológico en Guatemala y establecer las características asociadas a esta infección fúngica. Métodos: Estudio observacional prospectivo de agosto a diciembre de 2012. Se obtuvieron muestras de uñas de pacientes con onicomicosis distrófica total para identificar los agentes causales en cultivo de agar dextrosa Sabouraud y Mycosel®. Resultados: 32 de 130 pacientes tenían onicomicosis mixta. 68.5% se asociaron a tinea pedis. La asociación más común fue entre T. rubrum + Candida, T. rubrum + M. canis y T. rubrum + hongos oportunistas. Conclusiones: La onicomicosis mixta representa el 25% de la onicomicosis distrófica total en Guatemala. Observamos una relación importante entre la diabetes y la asociación principal fue T. rubrum con Candida spp.

Atherosclerosis Obliterans-induced Foot Ulcer Confused with Secondary Bacterial Infection Accompanying Tinea Pedis / 대한피부과학회지

No abstract available.

Analysis on curative effects and safety of 2% liranaftate ointment in treating tinea pedis and tinea corporis and cruris

The paper is intended to analyze and evaluate the specific curative effect and safety of 2% liranaftate ointment in treating patients with tinea pedis and tinea cruris. 1,100 cases of patients with tinea pedis and tinea corporis and cruris were selected as research objects and were divided into two groups according to the random number table method. They were treated with different methods: 550 cases of patients were treated with 2% liranaftate ointment for external use in the observation group and the rest 550 cases of patients were treated with 1% bifonazole cream in the control group. The treatment time was two weeks for patients with tinea corporis and cruris and four weeks for those with tinea pedis respectively. Meanwhile, the one-month follow-up visit was conducted among the patients to compare the curative effects of two groups. After the medication, the curative effectiveness rate was 87.65% [482/550] in the observation group, while that was 84.91% [467/550] in the control group. After the average follow-up visits of [15.5 +/- 2.4], the curative effectiveness rate 96.55% [531/550] in the observation group, while that was 91.45% [503/550] in the control group. Two groups of patients recovered well with a low incidence of adverse reactions in the treatment, and the overall curative effect was good with the inter-group difference at P>0.05, so it was without statistical significance. The curative effect of 2% liranaftate ointment is safe and obvious in treating tinea pedis and tinea corporis and cruris, so it is valuable for clinical popularization and application

Kerion Celsi Caused by Trichophyton rubrum in an Elderly / 대한의진균학회지

Kerion celsi is a severe inflammatory type of tinea capitis that presents as a boggy mass studded with broken hairs, oozing purulent material from follicular orifices. This infection is caused most commonly by zoophilic or geophilic pathogens. Trichophyton(T.) rubrum is an anthropophilic dermatophyte that is found all over the world. It has become one of the most important causative agents in tinea unguium and tinea pedis. But, kerion celsi caused by T. rubrum is rare. Kerion celsi is uncommon in adult. We report a case of kerion celsi caused by T. rubrum in a 72-year-old woman. She presented with localized tender erythematous plaques with pustules with oozing purulent material on the frontal scalp. A fungal culture from tissue of the lesions was grown on Sabouraud's dextrose agar and showed typical whitish cottony colonies of T. rubrum. The nucleotide sequence of internal transcribed spacer region for clinical isolate was identical to that of T. rubrum strain UZ1588_14 (GenBank accession number KP326579.1). She was treated with 200 mg of oral itraconazole daily for 3 months. The skin lesions improved 1 month after treatment, and recurrence has not been observed.

A Case of Recalcitrant Tinea Pedis caused by Trichosporon asahii / 대한의진균학회지

No abstract available.

Clinical Study of Onychomycosis Observed in Children (2005~2014) / 대한피부과학회지

BACKGROUND: Pediatric onychomycosis has been previously investigated; however, the specific causative agents of onychomycosis in Korean children have not been reported. OBJECTIVE: This study aimed to determine the most common causative agents of onychomycosis in Korean children. METHODS: We reviewed the medical records of 149 pediatric patients (<18 years of age) referred for fungal cultures because of a clinical suspicion of onychomycosis between 2005 and 2014 at our clinic. Patient specimens were cultured on Sabouraud's dextrose agar with and without cycloheximide. RESULTS: Onychomycosis was clinically suspected in 149 children. Of the 44 patients with onychomycosis, confirmed by culture, 72.7% had toenail onychomycosis, 22.7% had fingernail onychomycosis, and 4.5% had toenail and fingernail onychomycosis. The male-to-female patient ratio was 1.93:1. Fourteen (31.8%) children had concomitant tinea pedis, and 12 (27.2%) had family members with tinea pedis or onychomycosis. Distal and lateral subungual onychomycosis were the most common (68%) clinical types. Trichophyton rubrum was the most frequently isolated pathogen (66.7%), followed by Candida albicans (14.8%), Microsporum canis (11.1%), Candida parapsilosis (3.7%), and Candida tropicalis (3.7%). Candida albicans was the most commonly isolated pathogen (50.0%) in fingernail onychomycosis. CONCLUSION: Pediatric onychomycosis is more common than most people think. Thus, we suggest the need for a careful mycological examination of children with suspected onychomycosis.

Dermatophytes and other associated fungi in patients attending to some hospitals in Egypt

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.

Índice de severidad y afectación en la tiña pedis / Severity index involvement in tinea pedis

INTRODUCCIÓN: la tiña pedis es una infección por dermatofitos que afecta a los pies e invade frecuentemente los espacios interdigitales, bordes laterales y plantas, la cual tiene una alta incidencia, tendencia a las recidivas y rebeldía a los tratamientos. OBJETIVO: evaluar la severidad de la tiña pedis escamosa a través del índice de severidad y afectación de la tiña pedis (ISATP), MÉTODOS: estudio de evaluación en 347 pacientes a los que se les diagnosticó tiña pedis escamosa, que se atendieron por la especialidad de Dermatología del Hospital Militar Central "Dr. Carlos J Finlay", entre septiembre de 2010 y septiembre de 2012. Se aplicó el algoritmo ISATP, desarrollado a partir del índice de severidad y área de psoriasis (PASI). RESULTADOS: predominó el ISATP moderado con 46,6 %. La mayor frecuencia se encontró en el grupo de 46 a 55 años (55,9 %) y en el sexo masculino (73,1 %). Según el color de la piel, los pacientes de piel blanca (40,0 %) tuvieron el primer lugar. El ISATP severo prevaleció en el grupo etario de 56 a 65 años (50,0 %), en el sexo masculino (93,5 %) y en los pacientes de color de la piel negra (65,7 %). CONCLUSIONES: se comprobó que el algoritmo empleado, ISATP, es útil para definir los grados de severidad de las tiñas pedis escamosas de los pacientes en leves, moderados y severos; además permite relacionarlos con variables definidas de edad, sexo y color de la piel.

INTRODUCTION: tinea pedis is a dermatophyte infection that affects feet and areas between toes, it often invades edges, sides and plants, it has a high incidence, tendency to relapse and rebellious to treatment. OBJECTIVE: assess the severity of flaky tinea pedis through the rate of severity and impairment of tinea pedis (ISATP). METHODS: an assessment study was conducted in 347 patients who were diagnosed with flaky tinea pedis. They were assisted in Dermatology services at Military Central Hospital, from September 2010 to September 2012. The ISATP algorithm was applied. It was developed from psoriasis area and severity rate (PASI). RESULTS: moderate ISATP prevailed (46.6 %). It was most frequently found in the age group of 46-55 years (55.9 %), and in males (73.1 %). Depending on the color of skin, white patients (40.0 %) had the highest frequency. Severe ISATP prevailed in the age group of 56-65 years (50.0 %) in males (93.5 %) and in patients with black skin color (65.7 %). CONCLUSIONS: the algorithm used, ISATP, is useful to define the degree of severity of squamous tinea pedis in patients as mild, moderate and severe; also, it allows defining variables relate to age, sex and skin color.

Tinea Capitis Caused by Trichophyton rubrum in a 81-Year-Old Woman / 대한의진균학회지

Trichophyton(T.) rubrum is an anthropophilic dermatophyte that is found all over the world. It has become one of the most important causative agents in tinea pedis and onychomycosis. But tinea capitis caused by T. rubrum is rare. Tinea capitis is uncommon in an adult. We report a case of tinea capitis caused by T. rubrum in an 81-year-old woman. She presented with localized asymptomatic well-demarcated thick scaly erythematous patches on the fronto-vertex scalp for 6 months. She was diagnosed as seborrheic dermatitis in local clinic and was treated with topical steroid. However, the lesion was not improved and spreading. Culture from scalp lesion of patient was grown on Sabouraud's dextrose agar and showed typical whitish cottony colonies of T. rubrum. She was treated with 200 mg of oral itraconazole daily for 8 weeks. The skin lesions improved 8 weeks after treatment, and recurrence has not been observed.

Medicamentos orais para o tratamento do pé de atleta (tinea pedis) / Oral medications for the treatment of athlete's foot (tinea pedis)

Introdução: Cerca de 15% da população mundial tem pé de atleta ( frieira, ou tinea pedis), uma infecção fúngica do pé. Existem várias formas clínicas da doença; a tinea dos dedos do pé, da sola (interdigital), do calcanhar e lateral do pé (plantar) são as formas mais comuns. A tinha plantar é conhecida como ?pé em mocassim?. Uma vez adquirida, a in¬fecção pode disseminar-se para outras áreas do pé, inclusive para as unhas, que se tornam fonte de reinfecção. A terapia oral é frequentemente usada para quadros crônicos de tinea ou quando o tratamento tópico não resolveu o problema. Objetivos: Avaliar a efetividade dos tratamentos orais para infecções fúngicas da pele do pé (tinea pedis). Métodos: Métodos de busca: Para esta atualização da revisão, foram feitas buscas nas seguintes bases de dados até julho de 2012: Cochrane Skin Group Specialised Register, Central, Medline (a partir de 1946), Embase (a partir de 1974), e CINAHL (a par¬tir de 1981). Também foi feita uma busca nas referências bi¬bliográficas citadas nos estudos encontrados e nas platafor¬mas de registros de ensaios clínicos. Critérios de seleção: Ensaios clínicos controlados e ran¬domizados que avaliaram medicamentos orais para partici¬pantes com diagnóstico clínico de tinea pedis, confirmado pela microscopia e pelo crescimento de dermatófitos ( fun¬gos) na cultura. Coleta de dados e análise: Dois autores da revisão realiza¬ram a seleção de estudos, a avaliação do risco de viés e a extra¬ção de dados, de modo independente. Principais resultados: Incluímos 15 ensaios clínicos que envolveram 1.438 participantes. Segundo dois ensaios clínicos (71 participantes) que compararam terbinafina versus griseo¬fulvina, a razão de risco (RR) de cura foi de 2.26 [intervalo de confiança de 95% (IC 95%) 1,49 a 3,44] em favor da terbinafina. Apesar de a maioria dos estudos ser pequena, não foi detectada

Clinical Features of Dermatology-Consulted Inpatients: Focus on the Differences between Individual Departments / 대한피부과학회지

BACKGROUND: A variety of dermatological disorders develop in hospitalized patients and the need for dermatological consultations is on the rise. OBJECTIVE: We analyzed 2 years of dermatological consultation data from a tertiary medical center in Korea and compared dermatological problems among individual departments. METHODS: We reviewed 3,102 dermatological inpatient consultations by performing a retrospective chart review. RESULTS: Contact dermatitis (11.4%), drug eruption (9.6%), tinea pedis (5.5%), xerotic eczema (5.3%), and seborrheic dermatitis (5.2%) were the 5 dermatological disorders that were most commonly referred to dermatologists. Patients in the allergy and pulmonology departments had higher rates of drug eruptions. Endocrinology-admitted patients, especially diabetic patients, frequently complained of foot dermatitis. The cardiology, gastroenterology, and hemato-oncology departments referred many patients with purpuric dermatosis to dermatologists. Patients from the surgical departments consulted more frequently consulted contact dermatitis and drug eruptions. The neurology and rehabilitation medicine departments referred more seborrheic dermatitis patients than other departments. Pediatric patients commonly consulted for atopic dermatitis, viral exanthemata, and seborrheic dermatitis. Regardless of department, patients who suffered from severe illness and underwent major surgery developed herpes zoster and cutaneous fungal infections more frequently than other patients. Personal hygiene was closely related to the development of follicular disorders. CONCLUSION: Dermatologists should be familiar with the diverse dermatological complaints of patients admitted to various departments and be actively involved in the diagnosis, treatment, and education of doctors and patients to improve the quality of inpatient care.

A Clinical Study of Inpatients with Cellulitis over the Recent 5 Years / 대한피부과학회지

BACKGROUND: Cellulitis is an acute infection of the dermal and subcutaneous layers of the skin, which is commonly treated by a dermatologist but there are few reports about clinical data on cellulitis in Korean literature. OBJECTIVE: This study evaluated the clinical characteristics of inpatients diagnosed as cellulitis in the recent 5 years. METHODS: We reviewed the medical records of 77 patients who were diagnosed as cellulitis and hospitalized at the Kangbuk Samsung Hospital from March 2008 to February 2013. RESULTS: The study included data from 77 patients with cellulitis (mean age, 51.7 years; 44 men, 33 women). There was a positive correlation between age and hospitalized days (p0.05). Systemic steroid was administered in 21 patients (27.3%), and was not significantly related to hospitalized days (p>0.05). CONCLUSION: The clinical course of cellulitis was inversely correlated to the elevation of patient's age, WBC count, and CRP.

Comparative Study of In Vitro Inhibitory Effects of UVC, Terbinafine Hydrochloride 1% and Paeonia Natural Extracts on Trichophyton rubrum / 대한의진균학회지

BACKGROUND: Trichophyton(T.) rubrum is most common fungal pathogen that causes tinea pedis and onychomycosis. It recurrently infects human and usually persists for very long time, provoking public health concern. Due to the limitation in current treatment options, alternative therapies are desirable. We investigated the inhibitory effect of UVC, terbinafine hydrochloride 1% and paeonia natural extracts on T. rubrum in vitro. OBJECTIVE AND METHOD: Total 25 T. rubrum strains were cultured for 10 days on Mycosel agar plate; 5 strains of T. rubrum and 5 copies for each strain. They were divided into 5 groups: control, UVC irradiation, terbinafine spray, paeonia natural extracts spray, UVC and paeonia natural extracts sprays. The cultured media were irradiated for 1 hour daily for 3 weeks in the germicidal lamp emitting 253.7 nm (UVC), power of 2.875 mW/cm2 at 10 cm distance. Terbinafine and paeonia extracts was sprayed twice on the surface to fully cover the colony area. The median diameter of each colony were measured every other day for 3 weeks. The change of colony diameter and the growth rate were analyzed. RESULTS: The UVC had virtually no effect on restraining the growth of T. rubrum, similar with the growth of the control group. However, both the terbinafine spray and paeonia extracts slowed down the growth rate remarkably and showed a similar effect. CONCLUSION: We could only figure out the fungistatic effect, and not the fungicidal effect of paeonia extract and terbinafine hydrochloride in vitro. UVC irradiation setting in this study was totally ineffective. More studies are needed on more variable wavelength and the fluence of UVC irradiation. In addition, further verification on the mechanism and the effect of anti-fungal activity by paeonia extracts are needed.

Isolation of Trichophyton rubrum from Diabetic Foot Ulcers of 4 Patients / 대한의진균학회지

Trichophyton rubrum is a common cause of superficial dermatophytosis in humans, such as tinea pedis, tinea unguium, tinea corporis and tinea cruris. T. rubrum usually attaches to keratin of the epidermis and uses it as a source of nutrients. Therefore, isolation of T. rubrum from non-keratinous skin, such as ulcer, is very rare. We describe 4 patients with T. rubrum-infected diabetic foot ulcer.

Tiña negra (tinea nigra): comunicación de un caso alóctono en Chile / Tinea Nigra: a allochthonous case report in Chile

Tinea nigra is a superficial mycosis caused by Hortaea werneckii. It is an infrequent asymptomatic infection that affects mainly human palms and soles, and it is mostly seen in tropical countries. It has not been reported in Chile yet. The clinical presentation is generally a single macule, not symptomatic, of brown color in palms and soles. We report a case of a Chilean woman that developed brown macules on both soles after travel to the United States and Central America. The diagnosis of Tinea nigra was confirmed by direct microscopic examination and mycological culture. She had a good response to treatment with oral itraconazol.

La tiña negra (tinea nigra) es una micosis cutánea causada por Hortaea werneckii. Es poco frecuente, limitada a países tropicales o subtropicales. Hasta la presente publicación, esta micosis no había sido comunicada en Chile. La presentación clínica es generalmente una mácula única, asintomática, color café en palmas y plantas. Se presenta el caso de una mujer chilena, que después de varios viajes a E.U.A y Centroamérica, presentó manchas color café en ambas plantas. Se confirmó el diagnóstico de tiña negra con un examen microscópico directo y cultivo micológico. La paciente presentó una buena respuesta clínica luego del tratamiento con itraconazol por vía oral.

Prevalence of athlete's foot in Bahrain Royal Navy

Tinea pedis is a very common infection especially in the army and limited studies have been performed to establish the prevalence and associations and had never been performed in the Kingdom of Bahrain. To evaluate the prevalence of tinea pedis in Bahrain Royal Navy. A cross-sectional study. Bahrain Royal Navy. One hundred and eighty-three individuals were randomly selected, interviewed and examined by physicians. The result was incorporated into SPSS software to establish the prevalence and associations. Affected individuals were sent to the Naval Medical Centre for proper medical management. Sixty-four out of 183 subjects were clinically infected with tinea pedis, point prevalence of 35%. Forty-two [65.6%] were unaware of the infection, 5 [7.8%] were diabetics and 17 [26.6%] sought treatment in the past. Thirty-four [53.1%] were Bahrainis and 38 [59.4%] of the affected individuals were living in the naval base. Twenty-nine [45.3%] patients were aged 40-60 years and 34 [53.1%] patients served the military 11-20 years. Tinea pedis is a very prevalent infection among Bahrain Royal Navy personnel. Maintenance of personal and environmental hygiene is crucial and must be implemented to reduce the morbidity of this disease in all army personnel

Onychomycosis in Children: An Experience of 59 Cases

BACKGROUND: Although tinea unguium in children has been studied in the past, no specific etiological agents of onychomycosis in children has been reported in Korea. OBJECTIVE: The purpose of this study was to investigate onychomycosis in Korean children. METHODS: We 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. RESULTS: Onychomycosis 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%). CONCLUSION: Because of the increase in pediatric onychomycosis, we suggest the need for a careful mycological examination of children who are diagnosed with onychomycosis.

Onychomycosis in Children: An Experience of 59 Cases

BACKGROUND: Although tinea unguium in children has been studied in the past, no specific etiological agents of onychomycosis in children has been reported in Korea. OBJECTIVE: The purpose of this study was to investigate onychomycosis in Korean children. METHODS: We 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. RESULTS: Onychomycosis 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%). CONCLUSION: Because of the increase in pediatric onychomycosis, we suggest the need for a careful mycological examination of children who are diagnosed with onychomycosis.