scholarly journals Overall Prevalence and Prevalence Compared among Psoriasis Treatments of Onychomycosis in Patients with Nail Psoriasis and Fungal Involvement

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Leena Chularojanamontri ◽  
Penvadee Pattanaprichakul ◽  
Charussri Leeyaphan ◽  
Panittra Suphatsathienkul ◽  
Supisara Wongdama ◽  
...  
Keyword(s):  
Demographic Data ◽  
Periodic Acid ◽  
Causative Organism ◽  
Interleukin 17 ◽  
Fungal Culture ◽  
Candida Spp ◽  
Biologic Treatment ◽  
Nail Psoriasis ◽  
Treatment Groups ◽  
Psoriasis Severity

Background. Whether nail psoriasis can increase the risk of onychomycosis is still being debated, and data relating to the prevalence of onychomycosis among psoriasis patients receiving different treatments is limited. Objectives. To investigate the overall prevalence and prevalence compared among psoriasis treatments of onychomycosis in patients with nail psoriasis and fungal involvement. Methods. A prospective study of three groups of nail psoriasis being treated with only topical medication, methotrexate, or biologics (25 patients per group, 150 nails) was conducted at Siriraj Hospital (Bangkok, Thailand) during November 2018 to September 2020. Demographic data, psoriasis severity, and nail psoriasis severity were recorded. The nail most severely affected with psoriasis on each hand was selected for mycological testing. Potassium hydroxide, periodic acid-Schiff stain, and fungal culture were performed. Results. The prevalence of onychomycosis in nail psoriasis was 35.3%. Among the treatment groups, the prevalence of onychomycosis was significantly higher in the methotrexate group than in the topical treatment and biologic treatment groups ( p = 0.014 ). Candida spp. was the main causative organism, followed by Trichophyton rubrum. Thumb was most commonly affected (59.3%). The most common abnormality of the nail matrix and the nail bed was pitted nail (71.3%) and onycholysis (91.3%), respectively. Multivariate analysis revealed diabetes, wet-work exposure, and methotrexate treatment to be predictors of onychomycosis. Conclusions. Several factors, including psoriasis treatment, were shown to increase the risk of onychomycosis in nail psoriasis. Further research is needed to determine whether biologic agents, especially interleukin-17 inhibitors, can increase risk of onychomycosis and Candida infection/colonization of the nails.

scholarly journals A Comparison of The Effects of Clobetasol 0.05% and Photodynamic Therapy Using Aminolevulinic Acid With Red Light in the Treatment of Severe Nail Psoriasis

2020 ◽  
Vol 11 (1) ◽  
pp. 3-7
Author(s):  
Zohreh Tehranchinia ◽  
Nasibeh Barzkar ◽  
Seyed Mohammad Riahi ◽  
Marjan Khazan
Keyword(s):  
Photodynamic Therapy ◽  
Aminolevulinic Acid ◽  
Red Light ◽  
Severity Index ◽  
Therapy Resistance ◽  
Intense Pain ◽  
Nail Psoriasis ◽  
Treatment Groups ◽  
Psoriasis Severity

Introduction: The treatment of nail psoriasis is often difficult and unsatisfactory due to therapy resistance. This study aimed to compare the efficacy of clobetasol 0.05% ointment and photodynamic therapy (PDT) using aminolevulinic acid (ALA) and red light in the treatment of severe nail psoriasis. Methods: This open-trial study included 69 nails of 8 patients with severe nail psoriasis. Thirty-four nails were treated with clobetasol 0.05% ointment and 35 nails were treated with ALA-PDT. ALAPDT treatment was performed every 3 weeks for 5 cycles; the nails were treated with clobetasol under occlusion every day during the study. All the patients were followed up after 24 weeks. The severity of nail involvement was measured by the Nail Psoriasis Severity Index (NAPSI) scores at the baseline and during the treatment. Results: There were no significant differences in the NAPSI scores between the treatment groups in the baseline and weeks 3, 6 and 9 (all P>0.05), although significant differences were found in weeks 12, 15 and 24 (follow-up) (P<0.001). A significant time-effect improvement was found in all the nailmatrix, nail-bed and total NAPSI scores in both treatment groups (all P<0.001). The patients did not report intense pain and discomfort during irradiation. Conclusion: Clobetasol 0.05% ointment seems to be effective in treating nail psoriasis after a treatment period of 15 weeks. However, the efficacy of ALA-PDT at a 24-week follow-up was greater than that of clobetasol.

Modification of the nail psoriasis severity index

2005 ◽  
Vol 53 (4) ◽  
pp. 745-746 ◽  
Author(s):  
Charles A. Parrish ◽  
Jenny O. Sobera ◽  
Boni E. Elewski
Keyword(s):  
Severity Index ◽  
Nail Psoriasis ◽  
Psoriasis Severity

Interobserver reliability of the Nail Psoriasis Severity Index

2007 ◽  
Vol 32 (2) ◽  
pp. 141-144 ◽  
Author(s):  
Ş. Aktan ◽  
T. İlknur ◽  
Ç. Akin ◽  
Ş. Özkan
Keyword(s):  
Interobserver Reliability ◽  
Severity Index ◽  
Nail Psoriasis ◽  
Psoriasis Severity

Invited reply to “Possible reconsideration of the Nail Psoriasis Severity Index (NAPSI) score”

2013 ◽  
Vol 69 (6) ◽  
pp. 1054 ◽  
Author(s):  
Haike M.J. van der Velden ◽  
Karlijn M.G. Klaassen ◽  
Peter C.M. van de Kerkhof ◽  
Marcel C. Pasch
Keyword(s):  
Severity Index ◽  
Nail Psoriasis ◽  
Psoriasis Severity

Study of spectrum of fungal isolates in the sputum of newly diagnosed pulmonary tuberculosis patients

2021 ◽  
pp. 004947552110546
Author(s):  
Abdul Raouf Wani ◽  
Lokender Kumar ◽  
Ritu Singhal ◽  
Amartya Chakraborti ◽  
Sagar Mohanrao Khot
Keyword(s):  
Pulmonary Tuberculosis ◽  
Significant Proportion ◽  
Fungal Culture ◽  
Newly Diagnosed ◽  
Candida Spp ◽  
Duration Of Symptoms ◽  
Fungal Colonisation ◽  
Fungal Isolates ◽  
Low Body Mass Index ◽  
Independent Risk Factors

Tuberculosis is a state of immunosupression which exposes the patients to further opportunistic pathogens like fungus. Methods: 102 newly diagnosed sputum positive pulmonary tuberculosis cases were enrolled. Significant fungal isolates were seen in 31/102 (30.4%) patients. Aspergillus spp. were isolated in 13/31(41.9%) of the positive fungal cultures while Candida spp. were isolated in 15/31 (48.4%). Low body mass index, duration of symptoms, haemoptysis, severity of radiological features and IgG Aspergillus antibodies were independent risk factors for positive fungal culture. Significant proportion of patients with PTB have fungal colonisation of their airways which can lead to poor clinical outcomes. Few easily ascertained clinical parameters can help the clinician to determine patients who are at a higher risk of fungal colonisation.

Analysis of factors related to the development of ventilator-associated pneumonia: use of existing databases

2000 ◽  
Vol 9 (5) ◽  
pp. 344-349 ◽  
Author(s):  
JF Byers ◽  
ML Sole
Keyword(s):  
Mechanical Ventilation ◽  
Length Of Stay ◽  
Odds Ratio ◽  
Demographic Data ◽  
Tube Feeding ◽  
Causative Organism ◽  
Trauma Patients ◽  
Ventilator Associated Pneumonia ◽  
Receptor Antagonists ◽  
Level I

OBJECTIVE: To investigate factors related to ventilator-associated pneumonia to assist in the development and implementation of prevention strategies. METHODS: A retrospective, descriptive design was used. Power analysis determined sample size. A consecutive sample of 120 patients admitted to the critical care units of a level I trauma center who were receiving mechanical ventilation was used. Data were obtained from clinical and financial databases. Variables included demographic data, causative organism of the pneumonia, medications, comorbid conditions, complications, duration of therapies, length of stay, and cost per case. RESULTS: The average patient was a 49-year-old man. The sample was 54.9% trauma patients, and the prevalence of ventilator-associated pneumonia was 16.7%. Significant factors included duration of intubation (r = 0.28, P = .005), mechanical ventilation (r = 0.26, P = .005), and tube feeding (r = 0.30, P = .001); trauma (phi = 0.24, P = .009); and use of histamine2 receptor antagonists (phi = -0.25, P = .006). The only variable that significantly increased the odds ratio for ventilator-associated pneumonia was trauma. The only variable that significantly decreased the odds ratio was use of histamine2 receptor antagonists. Patients in whom ventilator-associated pneumonia developed had a 16-day increase in length of stay (t = -2.68, P = .008), and a $29,369 increase in cost per case (t = -3.649, P = .000). CONCLUSIONS: These findings provide a baseline for discussions about potential changes in practice to help prevent ventilator-associated pneumonia.

Possible reconsideration of the Nail Psoriasis Severity Index (NAPSI) score

2013 ◽  
Vol 69 (6) ◽  
pp. 1053-1054 ◽  
Author(s):  
Alice Garzitto ◽  
Federica Ricceri ◽  
Lara Tripo ◽  
Leonardo Pescitelli ◽  
Francesca Prignano
Keyword(s):  
Severity Index ◽  
Nail Psoriasis ◽  
Psoriasis Severity

Clinical Study of various Nail Disorders presenting to Dermatology Outpatient Department

2017 ◽  
Vol 2 (3) ◽  
pp. 125-129
Author(s):  
Praveen K Rathore ◽  
Sapna Goyal ◽  
Anuj Kumar ◽  
Parul Garg
Keyword(s):  
Clinical Study ◽  
Potassium Hydroxide ◽  
Outpatient Department ◽  
Fungal Culture ◽  
Nail Bed ◽  
Nail Psoriasis ◽  
Medical College ◽  
Gram Staining ◽  
Nail Discoloration ◽  
Pachyonychia Congenita

ABSTRACT Aims and objectives To study the clinical spectrum of nail disorders including congenital, developmental, infectious, neoplastic, degenerative, dermatological, and systemic diseases affecting the nail unit. Materials and methods A total of 100 consecutive cases of nail disorders reporting to the dermatology outpatient department in Rohilkhand Medical College & Hospital were examined. Complete dermatological, systemic, hematological examinations, Gram staining, scraping for fungus, nail clipping for potassium hydroxide mount, fungal culture, biopsy from nail bed were undertaken in doubtful cases. Observations and results Among 100 cases, the most common was onychomycosis — 28 cases, followed by nail psoriasis — 13 cases, pitting — 10 cases, paronychia — 9 cases, trachyonychia — 5 cases, onycholysis — 4 cases, clubbing — 3 cases, koilonychia — 3 cases, ingrow toenail — 3 cases, pterygium — 3 cases, onychogryphosis — 2 cases, subungual wart — 2 cases, half and half nail — 2 cases, anonychia — 2 cases, longitudinal grooves — 2 cases, clubbing with resorption of fingers — 2 cases, onychomadesis — 1 case, nail discoloration — 1 case, melanonychia — 1 case, pachyonychia congenita — 1 case, beau's line — 1 case, racket nail — 1 case, transverse groove — 1 case. Conclusion Among examined cases, onychomycosis was most common followed by another nail disorders. How to cite this article Garg P, Kumar A, Rathore PK, Goyal S. Clinical Study of various Nail Disorders presenting to Dermatology Outpatient Department. Int J Adv Integ Med Sci 2017;2(3):125-129.

Utility of Histopathologic Analysis in the Evaluation of Onychomycosis

2005 ◽  
Vol 95 (3) ◽  
pp. 258-263 ◽  
Author(s):  
Jeffrey M. Weinberg ◽  
Evelyn K. Koestenblatt ◽  
Maureen B. Jennings
Keyword(s):  
Potassium Hydroxide ◽  
Periodic Acid ◽  
False Negative ◽  
Nail Plate ◽  
Fungal Culture ◽  
Periodic Acid Schiff ◽  
Negative Results ◽  
False Negative Results ◽  
Histopathologic Analysis ◽  
Dermatophyte Infection

Onychomycosis is a common problem seen in clinical practice. Given the differential diagnosis of dystrophic nails, it is helpful to obtain a definitive diagnosis of dermatophyte infection before initiation of antifungal therapy. Potassium hydroxide preparation and fungal culture, which are typically used in the diagnosis of these infections, often yield false-negative results. Recent studies have suggested that nail plate biopsy with periodic acid–Schiff stain may be a very sensitive technique for the diagnosis of onychomycosis. In this article, we review the literature on the utility of histopathologic analysis in the evaluation of onychomycosis. Many of these studies indicate that biopsy with periodic acid–Schiff is the most sensitive method for diagnosing onychomycosis. We propose that histopathologic examination is indicated if the results of other methods are negative and clinical suspicion is high; therefore, it is a useful complementary technique in the diagnosis of onychomycosis. (J Am Podiatr Med Assoc 95(3): 258–263, 2005)

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