Eleonora Dubljanin1, Aleksandar Dzamic2, Isidora Vujcic3, Stefan Mijatovic2, Teodora Crvenkov4, Sandra Sipetic Grujicic3, Ivana Colovic Calovski2. 1. Institute of Microbiology and Immunology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia. eleonoraratkov@yahoo.com. 2. Institute of Microbiology and Immunology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia. 3. Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia. 4. Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Abstract
INTRODUCTION: Onychomycosis is a chronic fungal infection with increasing incidence and the global prevalence is estimated to be 5.5%. The aim of our study was to perceive objectively severity of onychomycosis by calculating Scoring Clinical Index for Onychomycosis and to correlate this index with accurate laboratory diagnosis in our patients. MATERIALS AND METHODS: The study population comprised of 417 patients with laboratory confirmed onychomycosis. For each patient, we recorded basic demographic information, site of infection, the most affected nail with onychomycosis, clinical presentation, and type of onychomycosis. The evaluation of the disease severity was based on Scoring Clinical Index for Onychomycosis which was calculated for every patient separately. Mycological identification was done by microscopy and fungal culture. RESULTS: The majority of patients had distal and lateral subungual onychomycosis (95.44%) that was localized on big toe (62.59%), with female to male ratio 1.24:1. Male patients had significantly more nails affected with onychomycosis compared with female patients (p = 0.011), while female had significantly more often onychomycosis on fingernails 2-5 (p < 0.05), and they reported significantly more often pain (p < 0.05) and esthetic problems (p < 0.05). Mean Scoring Clinical Index for Onychomycosis was 16.76. Dermatophytes were most frequently isolated (91.85%). In patients with onychomycosis caused by dermatophytes, Scoring Clinical Index for Onychomycosis had significantly higher values (p = 0.032). CONCLUSION: Comprehensive understanding of disease characteristics will allow introduction of individualized treatment plan for each patient, based on proper fungal identification and standardized method of evaluating disease severity, which could help the patient achieve a complete cure.
INTRODUCTION: Onychomycosis is a chronic fungal infection with increasing incidence and the global prevalence is estimated to be 5.5%. The aim of our study was to perceive objectively severity of onychomycosis by calculating Scoring Clinical Index for Onychomycosis and to correlate this index with accurate laboratory diagnosis in our patients. MATERIALS AND METHODS: The study population comprised of 417 patients with laboratory confirmed onychomycosis. For each patient, we recorded basic demographic information, site of infection, the most affected nail with onychomycosis, clinical presentation, and type of onychomycosis. The evaluation of the disease severity was based on Scoring Clinical Index for Onychomycosis which was calculated for every patient separately. Mycological identification was done by microscopy and fungal culture. RESULTS: The majority of patients had distal and lateral subungual onychomycosis (95.44%) that was localized on big toe (62.59%), with female to male ratio 1.24:1. Male patients had significantly more nails affected with onychomycosis compared with female patients (p = 0.011), while female had significantly more often onychomycosis on fingernails 2-5 (p < 0.05), and they reported significantly more often pain (p < 0.05) and esthetic problems (p < 0.05). Mean Scoring Clinical Index for Onychomycosis was 16.76. Dermatophytes were most frequently isolated (91.85%). In patients with onychomycosis caused by dermatophytes, Scoring Clinical Index for Onychomycosis had significantly higher values (p = 0.032). CONCLUSION: Comprehensive understanding of disease characteristics will allow introduction of individualized treatment plan for each patient, based on proper fungal identification and standardized method of evaluating disease severity, which could help the patient achieve a complete cure.
Authors: M A Ghannoum; R A Hajjeh; R Scher; N Konnikov; A K Gupta; R Summerbell; S Sullivan; R Daniel; P Krusinski; P Fleckman; P Rich; R Odom; R Aly; D Pariser; M Zaiac; G Rebell; J Lesher; B Gerlach; G F Ponce-De-Leon; A Ghannoum; J Warner; N Isham; B Elewski Journal: J Am Acad Dermatol Date: 2000-10 Impact factor: 11.527