Prevalence of oral mucosal lesions from birth to two years.

OBJECTIVE: The purpose of this study was to determine the prevalence of lesions of the oral mucosa from birth to two years in Turkish pediatric patients . MATERIALS AND METHODS: A total of 299 infants from newborn to two years of age were evaluated from the Outpatient Clinics of the Pediatric Department, in the Fatih University Hospital, Ankara, Turkey. The mucosal lesions were documented. The data were presented as percentages and for categorical comparisons Chi-square or Fisher's Exact test were used. A P-value less than 0.05 was considered statistically significant. RESULTS: Of the 299 infants, mucosal lesions were seen in only 65 (21.27%). In the study, the most common lesions were candidiasis (10.70%), Ebstein's pearls (2.68%), and geographic tongue (2.68%). The frequency of children with mucosal alterations was higher in the group of children from two to twelve months. CONCLUSIONS: Although the lesions that were found the most in our study were benign lesions, unrelated to systemic diseases, we still believe that oral mucosal lesions can be a sign of a systemic or dermatological disease in infants, which affects the oral feeding of the infants. Routine examination of the oral mucosa should be a part of the pediatric examination.

Nail alterations in 250 infant patients: a clinical study.

AIMS: To investigate the frequency and the nature of nail alterations in infants. STUDY DESIGN: A total of 250 infant patients from newborn to 2 years of age were evaluated from the outpatient clinics of paediatrics and dermatology departments, Fatih University Hospital. The nail alterations were documented. The data were presented as percentages, and for categorical comparisons, Chi-squared or Fisher's Exact test were used. P < 0.05 was considered statistically significant. RESULTS: Of the 250 infant patients, nail alterations were seen in only 17 (6.8%). Most of the patients had toe nail involvement. In 12 of 17 (70.6%) infants, there was one type of nail alteration; in 4 of 17 (23.5%) infants, there was two type of nail alterations; and in 1 of 17 (5.9%) infants, there was three type of nail alterations. The most frequent diagnosis was onychoschizia in 6 of 17 (2.4%) and congenital hypertrophy of the lateral nail fold together with ingrown nail in 6 (2.4%) infants. CONCLUSION: Because nail alterations could be a manifestation of systemic or dermatologic diseases in infants, fingernail and toenail examination should be a part of the paediatric dermatology examination.

In vitro antifungal susceptibility patterns of dermatophyte strains causing tinea unguium.

BACKGROUND: Dermatophytes are the major responsible organisms in onychomycosis. Although recent antifungal agents have high success rates in treating this condition, lack of clinical response may occur in 20%. Antifungal drug resistance may be one of the causes of treatment failure. The need for in vitro antifungal drug resistance in daily practice is still under discussion. OBJECTIVE: We aimed to determine the in vitro susceptibility patterns of dermatophytes causing onychomycosis, against the traditionally available systemic antifungal agents terbinafine, itraconazole and fluconazole. METHODS: In total, 100 otherwise healthy patients with suspected onychomycosis were included. Nail clippings were cultured on Sabouraud dexrose agar, mycobiotic agar and dermatophyte test medium. Antifungal susceptibility tests were carried out, mainly following The National Committee for Clinical and Laboratory Standards (M38-P) protocol standard for filamentous fungi. Different concentrations of terbinafine (0.008-8 microg/mL), itraconazole (0.015-16 microg/mL) and fluconazole (0.06-64 microg/mL) were tested. Minimum inhibitory concentration end-point determination was chosen as 100% growth inhibition for terbinafine and 80% for azoles. RESULTS: Of the 100 nail samples, 43% grew dermatophytes. The main causative organism was Trichophyton rubrum (91%) followed by Trichophyton mentagrophytes (9%). Terbinafine had the lowest minimum inhibitory concentration (0.008 microg/mL) followed by itraconazole. Fluconazole showed the greatest variation in minimum inhibitory concentration (0.03-2 microg/mL) and had different susceptibility patterns for the two species. CONCLUSIONS: Of the three antifungals tested, terbinafine had the most potent in vitro antifungal activity against dermatophytes. Antifungal susceptibility tests would be useful to screen antifungal-resistant dermatophyte strains.