Dermoscopic Features of Toenail Onychomycosis

2020 ◽  
Vol 110 (3) ◽  
Author(s):  
Noureddine Litaiem ◽  
Ines Nakouri ◽  
Sabrine Bouhlel ◽  
Yasmine Mansour ◽  
Meriem Bouchakoua ◽  
...  
Keyword(s):  
Candida Albicans ◽  
Lichen Planus ◽  
Trichophyton Rubrum ◽  
Nail Plate ◽  
Final Diagnosis ◽  
Published Data ◽  
Fungal Culture ◽  
Proximal Margin ◽  
Culture Positive ◽  
Clinical Subtype

Background Onychomycosis is the most common infectious nail disorder. Direct mycologic examination is still the cornerstone of diagnosis; however, it may take several weeks to obtain a result. Recently some dermoscopic patterns that can be useful in the diagnosis of onychomycosis were described. However, published data on dermoscopic features of onychomycosis are still limited. Methods We performed a prospective dermoscopic study of patients with positive fungal culture between April and December 2016. Patients with a final diagnosis of psoriasis or lichen planus were excluded from the study. Dermoscopy (polarized and nonpolarized) was performed. Results Thirty-seven patients were enrolled, 24 women and 13 men (median ± SD age, 48.6 ± 16.1 years). Nail samples were culture positive for Trichophyton rubrum (89.2%), Trichophyton interdigitale (8.1%), and Candida albicans (2.7%). Distal and lateral subungual onychomycosis was the most frequent clinical subtype (59.5%). The most frequent dermoscopic features were subungual keratosis (73.0%), distal subungual longitudinal striae (70.3%), spikes of the proximal margin of an onycholytic area (59.5%), transverse superficial leukonychia (29.7%), and linear hemorrhage (13.5%). Brown chromonychia was most frequently seen with nonpolarized dermoscopy (66.6% versus 24%; P = .027). Conclusions Specific dermoscopic signs of onychomycosis are mostly related to the proximal invasion of the nail plate. Detection of these signs is simple and can, in some cases, help avoid mycologic testing.

scholarly journals Fungal infection profile in burn patients at a tertiary care centre of India

2018 ◽  
Vol 6 (8) ◽  
pp. 2633
Author(s):  
Imran Ahmad ◽  
Mohammed Fahud Khurram ◽  
Sudheer Kumar Maurya ◽  
Rajesh Kumar Maurya ◽  
Mohd. Tafazul Sheikh
Keyword(s):  
Candida Albicans ◽  
Fungal Infection ◽  
Bacterial Infections ◽  
Late Onset ◽  
Tertiary Care ◽  
Morbidity And Mortality ◽  
Fungal Culture ◽  
Burn Patients ◽  
Burn Wound ◽  
Culture Positive

Background: Burn patients are at high risk of infections and burn wound infection is one of the most important factor responsible for their morbidity and mortality. Burn patients have increased incidence of fungal infection in comparison to others. Fungal infection is difficult to diagnose because it has similar symptoms like bacterial infections. Common fungal organism causing burn wounds infections are Candida sp., Aspergillus sp., non albicans Candida, Zygomycetes etc.Methods: This prospective study was carried out in Department of Burn, Plastic and Reconstructive Surgery, J.N.M.C.H., Aligarh Muslim University, India from December 2015 to June 2017. Patients having 20 to 60% body surface area involvement with more than 5 years of age with no comorbidity were included in this study.Results: In our study, total 126 patients were included, 9 male patients (18.37%) were found fungal culture positive whereas 14 females (18.18%) were culture positive. 12 patients (9.52%) were found to be positive for Candida albicans, 6 patients (4.76%) were Aspergillus flavus positive, 3 patients (2.38%) were positive for Non Candida albicans and 2 patients (1.59%) were positive for Aspergillus niger.Conclusions: Fungal burn wound infections are one of the most common cause of late onset morbidity and mortality in burn patients. So, high level of suspicion and tissue culture are essential in making early diagnosis and treatment. Judicious use of antibiotics are also necessary for decreasing its incidence.

scholarly journals Fungal lesions of the nail plate in patients from the Warmian-Masurian Voivodeship - analysis and discussion of the results of studies carried out in 2014 - 2019

2020 ◽  
pp. 41-45
Keyword(s):  
Candida Albicans ◽  
Candida Parapsilosis ◽  
Trichophyton Rubrum ◽  
Nail Plate ◽  
Trichophyton Mentagrophytes ◽  
Etiologic Agent ◽  
Etiological Factors ◽  
Positive Results

Introduction: The aim of the study was to analyze the results of mycological cultures obtained in the years 2014-2019. The study included an analysis of the incidence of mycosis with regard to their location, as well as the proportion of individual etiological factors in the infection. Methods: The study included materials from 999 patients who gave a total of 1103 cultures. The material was taken directly from the material and mycological cultures were established. Results: Positive results accounted for 35,8%. Trichophyton rubrum (44.2%) was the most common etiologic agent of dermatophytes. Among the yeast-like fungi, Candida albicans (8.8%) and Candida parapsilosis (7,6%) were the most common. Conclusions: Infectious lesions were mainly caused by dermatophytes, where Trichophyton rubrum and Trichophyton mentagrophytes dominated.

scholarly journals Photodynamic Eradication of Trichophyton rubrum and Candida albicans

Pathogens ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 263
Author(s):  
Anton Valkov ◽  
Michael Zinigrad ◽  
Marina Nisnevitch
Keyword(s):  
Methylene Blue ◽  
Candida Albicans ◽  
Photodynamic Therapy ◽  
Trichophyton Rubrum ◽  
Nail Plate ◽  
Correct Choice ◽  
Individual Response ◽  
Glycerol Water ◽  
New Methods ◽  
Malachite Green Oxalate

Conventional methods of onychomycosis treatment are ineffective in some cases because the cure of onychomycosis very often depends on the patient’s individual response to the treatment; therefore, there is a crucial need to research and develop new methods of onychomycosis therapy. One of the most innovative treatments is photodynamic therapy (PDT) using photosensitizers (PSs). However, effective treatment depends on the correct choice of photosensitizer and substances that improve the characteristics of the final formulation. The aim of our work was to find an effective formulation for the treatment of onychomycosis. To achieve this goal, we tested the effect of three types of PSs, rose Bengal (RB), malachite green oxalate (MGO), and methylene blue (MB), on Candida albicans. The most effective PS was RB, and so the study was continued with Trichophyton rubrum. Additional comparative studies were carried out on substances included in the formulation (urea and thiourea), focusing on their antifungal activity, which can improve penetration through the nail plate. The composition of the formulation that achieved 100% eradication of Trichophyton rubrum under our conditions consisted of 150 μM RB, 5% urea, and 0.5% thiourea in glycerol/water (70/30%, w/w) solution. A white luminescent lamp was used as a light source (1.9 ± 0.1 mW cm−2). Stability of the formulation was checked. The selected formulation shows potential for future simplification and acceleration of PDT treatment of onychomycosis.

scholarly journals A New In Vitro Model to Evaluate Anti-Adhesive Effect against Fungal Nail Infections

2021 ◽  
Vol 11 (5) ◽  
pp. 1977
Author(s):  
Paola Perugini ◽  
Margherita Bonetti ◽  
Marta Guerini ◽  
Giorgio Musitelli ◽  
Pietro Grisoli
Keyword(s):  
Candida Albicans ◽  
Social Life ◽  
In Vitro Model ◽  
Trichophyton Rubrum ◽  
Negative Impact ◽  
Nail Plate ◽  
Negative Control ◽  
Pharmaceutical Product ◽  
Vitro Model

Nail fungal infection is often mistakenly considered a minor issue or a purely esthetic problem that is not worth solving. However, onychomycosis has been demonstrated to have a negative impact on a patient’s social life. Therefore, given the poor efficacy of various therapy types, there is strong interest in exploring new methods for evaluating antifungal treatments. As such, the aim of this work was to develop a new protocol, using bovine hoof membranes as a model of the human nail to evaluate the capability of a product claiming to prevent fungal adhesion, which is the first step of the infection. In this work, two specific and representative fungal strains, Trichophyton rubrum and Candida albicans, were used. In order to evaluate the possible protective activity of a product against fungal contamination of the nail plate, it was first necessary to test the affinity of the hoof membranes to be contaminated by the fungi. Then, a pharmaceutical product and a base coat were tested as a positive and negative control, respectively, by introducing the membranes (anti-fungal, basic or no treatment and single vs. multiple treatments) into the fungal suspensions for three different contact times (15 min, 5 h and 24 h). The results showed that the more significant antiadhesive effect (AE) was obtained against Trichophyton rubrum than against Candida albicans. Furthermore, taking into account the results obtained at all testing times, 5 h appeared to be the best time for testing the antiadhesive activity. The results obtained after three treatments with drugs and on washed membranes, in comparison to one single application of antifungal product (AP), demonstrated clearly that the drug was able to penetrate deeper into the membranes to exert itself, even after washing and also after only 15 min of contact. Thus, hoof membrane has been shown to be a valuable in vitro model for this kind of product assessment.

Clinico-Mycological Study of Superficial Mycoses in a Tertiary Health Care Centre of Southern Assam

2021 ◽  
Vol 8 (5) ◽  
pp. 438-448
Author(s):  
Barnamoy Bhattacharjee ◽  
Atanu Chakravarty ◽  
Debadatta Dhar Chanda
Keyword(s):  
Health Care ◽  
Fungal Culture ◽  
Human Beings ◽  
Care Centre ◽  
Biochemical Tests ◽  
Health Care Centre ◽  
Superficial Mycoses ◽  
Slide Culture ◽  
Superficial Mycosis ◽  
Culture Positive

Background-Superficial Mycosis, which is the most common fungal infection affecting human beings, includes Dermatophytosis and Dermatomycoses, which are the infections of superficial keratinized layer of skin, nail & hair by Dermatophytes and non Dermatophytic moulds or yeasts respectively. This clinical entity is very common in hot, humid tropical climate of India with prevalence ranging from 30-60% but its precise case magnitude and epidemiology in North eastern India cannot be stated as there are only few studies conducted. So, this study is undertaken to 1) Find the prevalence of Superficial Mycosis in a tertiary health care centre of Southern Assam. 2) Study the clinical profile of the cases 3) Isolate and identify the causative agents of Superficial mycosis. Materials & Method- The study has been conducted on 250 samples from clinically suspected and untreated cases of superficial mycosis from Aug 2017 to Dec 2018. 2 separate sets of samples from edge of skin lesion/nail /hair were collected, of which 1 sample was subjected to direct microscopy with (10-40) % KOH and the other part was subjected to 2 sets of fungal culture in SDA tubes at 25°C and 37°C & followed for 3 weeks. In Culture positive cases, fungal identification was based on colony morphology, pigment production & LPCB mount. For confirmation of isolates, Slide Culture and biochemical tests were done. Result-Out of total 250 samples,115 samples (46%) showed presence of fungal elements in KOH examination, of which 73 were culture positive and of the KOH negative samples 10 samples were culture positive, thus making the prevalence 33.2% (83/250). Clinically, Tinea corporis was the most common form of both superficial mycosis & Dermatophytosis and Pityriasis Versicolor has been found the most common Dermatomycosis. Males(21-50yrs) were affected by superficial mycosis more than Females(16-30yr). Trichophyton mentagrophyte was the mostly isolated agent causing superficial mycosis. Keywords: Superficial mycoses, prevalence, Assam, Slide Culture, Urease.

scholarly journals Potentially pathogenic fungi in the material collected by the Specialist Regional Hospital, Łódź

2013 ◽  
Vol 45 (2) ◽  
pp. 197-205
Author(s):  
Magdalena Rusicka ◽  
Grażyna Lipowczan
Keyword(s):  
Candida Albicans ◽  
Trichophyton Rubrum ◽  
Pathogenic Fungi ◽  
Regional Hospital ◽  
Pathological Changes ◽  
Superficial Mycosis

The mycobiota responsible for the development of pathological changes of the skin and its adnexa in patients presenting at the Specialist Regional Hospital, Łódź, with suspected superficial mycosis between 01 May 2003 and 30 April 2005 is analyzed. In total of 2144 isolations 39.96% were dermatophytes, 39.39% were yeast-like fungi and 20.65% were moulds. <em>Candida albicans</em> was the most frequently diagnosed species in fallowed by <em>Trichophyton rubrum</em>.

scholarly journals Frecuencia de dermatomicosis y factores asociados en población vulnerable de la ciudad de Manizales. Colombia. 2011

2016 ◽  
Vol 18 (6) ◽  
pp. 953
Author(s):  
Gloria Ines Estrada Salazar ◽  
José A. Chacón-Cardona
Keyword(s):  
Candida Albicans ◽  
Trichophyton Rubrum ◽  
Culture Media ◽  
Trichophyton Mentagrophytes ◽  
Direct Analysis ◽  
Microsporum Gypseum ◽  
Epidermophyton Floccosum ◽  
Palabras Clave ◽  
Fusarium Sp ◽  
Cutaneous Mycosis

Resumen:Objetivo: Determinar la frecuencia de las dermatomicosis en personas de diferentes instituciones de atención social en la ciudad de Manizales durante el año 2011. Método: Mediante la toma de muestras de los sitios que presentaban algún tipo de lesión sospechosa de ser una micosis cutánea, se hizo un análisis directo con KOH y cultivo en medios de Saboureaud y Mycosel. Se aplicó un instrumento de recolección de información para establecer  factores asociados con la presencia de estos microorganismos.Resultados: Los hongos levaduriformes encontrados con mayor frecuencia fueron: Candida albicans, Trichosporon sp, y los mohos saprofitos Penicillium sp, fusarium sp; seguido de hongos dermatofitos como: Trichophyton mentagrophites, Trichophyton rubrum, Epidermophyton floccosum y Microsporum gypseum. Las lesiones secas y descamativas se encontraron con mayor frecuencia. El compartir baños y vivir en hacinamiento y el uso de elementos comunes fueron los factores asociados más importantes en este estudio.Conclusiones. Las dermatomicosis son frecuentes en poblaciones vulnerables y se asocian a diferentes factores muy similares a los encontrados en otros estudios de igual naturaleza.    Palabras clave: dermatomicosis, onicomicosis, jóvenes, ancianos, factores asociados. Summary:Objective: To determine the frequency of ringworm in people of different social care institutions in the city of Manizales in 2011.Method: Using the sampling sites that had some kind of suspicious lesion from a cutaneous mycosis, direct analysis with KOH and culture media was Saboureaud and Mycosel. An instrument of data collection was used to establish factors associated with the presence of these microorganisms.Results: The yeast found most frequently were: Candida albicans, Trichosporon sp and Penicillium molds saprophytes sp, Fusarium sp, followed by dermatophyte fungi such as Trichophyton mentagrophytes, Trichophyton rubrum, Epidermophyton floccosum and Microsporum gypseum. Dry scaly lesions were found more frequently. The shared bathrooms and living in overcrowded and the use of common elements were the most important in this study associated factors.Conclusions: Dermatomycoses are common in vulnerable populations and are associated with different very similar to those found in other studies of the same nature factors. Keywords: ringworm, onychomycosis, young, old, associated factors.

scholarly journals Comentarios biomorfológicos y clínicos sobre el género fusarium. Hialohifomicosis en uñas

2019 ◽  
Vol 3 (3) ◽  
Author(s):  
E. Piontelli L. ◽  
M. A. Toro S.M.
Keyword(s):  
Candida Albicans ◽  
Trichophyton Rubrum ◽  
Fusarium Spp ◽  
Scopulariopsis Brevicaulis

En una breve reseña sobre algunos aspectos biológicos, taxonómicos y clínicos inherentes al género Fusarium, se presentan 12 casos clínicos de hialohifomicosis en uñas y uno en córnea. La especie dominante fue F. oxysporum (8/12); F. moniliferme y F. solani se aislaron una sola vez, mientras Fusarium spp, 2 veces. La combinación de Fusarium con otra u otras especies, se detectó en 4 casos, ya sea junto a Trichophyton rubrum, T. mentagrophytes, Candida albicans y Scopulariopsis brevicaulis.

scholarly journals Comparative evaluation of KOH mount, fungal culture and PAS staining in onychomycosis

2019 ◽  
Vol 5 (3) ◽  
pp. 554
Author(s):  
Venkateswaramma Begari ◽  
Prathyusha Pathakumari ◽  
Anant A. Takalkar
Keyword(s):  
Andhra Pradesh ◽  
Histopathological Examination ◽  
Nail Plate ◽  
Fungal Culture ◽  
Highly Sensitive ◽  
Common Ailment ◽  
Pas Staining ◽  
Toe Nails ◽  
Morbid Conditions ◽  
Isolated Species

<p class="abstract"><strong>Background:</strong> Onychomycosis is a common ailment associated with significant physical and psychological morbidity. Increased prevalence in the recent years has attributed to enhanced longitivity, co morbid conditions like diabetes, avid spots participation and emergence of HIV. The objective of the study was to evaluate KOH mount, fungal culture and PAS staining of affected nail plate in diagnosis of onychomycosis.</p><p class="abstract"><strong>Methods:</strong> The present study was carried out in OPD of Dermatology, PESIMSR, Kuppam, Andhra Pradesh during the period of October 2010 to October 2012 including all patients showing classical clinical features of onychomycosis.<strong></strong></p><p class="abstract"><strong>Results:</strong> Majority of patients were from 21-40 years age group i.e. 46%. 56% of finger nails were commonly involved than 36% toe nails. DLSO is the most common clinical variant accounting for 80%. Most common isolated species as <em>Trichophyton rubrum </em>(31.6%) followed by <em>T. mentagrophytes</em> and <em>Aspergillus niger</em> 15.8% each. The sensitivity of KOH (81.82%), PAS (84.56%) and culture 57%. Both PAS and KOH were more sensitive than culture (p&lt;0.001). PAS was also more sensitive than KOH. The specificity of KOH 92.86%, culture 92.86% and PAS 57.14%.</p><p class="abstract"><strong>Conclusions:</strong> Fungal culture though is the gold standard for the identification of pathogens but it takes minimum 2-3 weeks. Histopathological examination of nail clippings with PAS stain is simple, highly sensitive screening test.</p>

Nail Changes in Lichen Planus: A Single-Center Study

2020 ◽  
pp. 120347542098255
Author(s):  
Magdalena Żychowska ◽  
Małgorzata Żychowska
Keyword(s):  
Lichen Planus ◽  
Nail Plate ◽  
Hair Follicles ◽  
Common Finding ◽  
Skin Area ◽  
Nail Changes ◽  
Single Center Study ◽  
The Subject ◽  
Nail Disease ◽  
Nail Involvement

Background Lichen planus (LP) is an inflammatory condition that can affect skin, mucous membranes, hair follicles, and/or nails. Nail abnormalities are estimated to occur in around 10% of LP cases. Clinical characteristics of nail involvement have been the subject of very few studies, which have mainly focused on isolated nail LP. Objectives To identify and describe nail alterations in patients with LP. Methods Seventy-five patients with cutaneous lichen planus (CLP) were included in the study. The diagnosis of LP was histologically confirmed in each case. Onychomycosis was excluded in each patient. Results Nail lesions were present in 21 (28%) patients (mean age 58.1 ± 12.55 years) with CLP. On an average, patients had 9.38 nails affected. A slight female preponderance was noted (57%). Nail involvement was independent of age, gender, presence of pruritus, the affected skin area, or the duration of CLP. The most common finding in the fingernails ( n = 122) was longitudinal ridging (85.2%), followed by nail plate thinning (38.2%) and onycholysis (17.2%). Pterygium formation (6.6%) and red lunulae (8.2%) were limited to the fingernails. In the fingernails, matrix involvement (98.4%) was more frequent than nail bed involvement (27%). The most common finding in the toenails ( n = 75) was hyperkeratosis (82.7%) with yellowish discoloration (69.3%). No cases of trachyonychia or anonychia were noted. Conclusions Nail abnormalities in patients with CLP may be more common than initially assessed. Rare formation of pterygium and absence of anonychia in patients with predominant cutaneous involvement might point at mild course of the nail disease in such cases.

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