A Study of Predisposing Factors and Treatment Responses in Streak Type Onychomycosis

Oh, Dae Heon; Eun, Chul; Kim, Jeong Soo; Yu, Hee Joon

Abstract

BACKGROUND
Human nails bear longitudinal furrows on both upper and lower surface. These furrows are formed as the nails grow and correspond to parallel dermal ridges irregularly distributed on the nail bed. Often there is fungal invasion in a longitudinal narrow band according to the furrows of the nail bed, clinically recognized streak type onychomycosis. OBJECTIVE: Our purpose was to investigate the clinical features, causative organisms, and predisposing factors and to evaluate the treatment responses of oral antifungal agent in streak type onychomycosis. METHODS: The study was conducted with 387 cases of onycomycosis (45 cases of streak type, 342 cases of non-streak type) and 50 normal controls examined at Department of Dermatology, Hanyang University Guri Hospital from June, 2001 to May, 2004. Streak type onychomycosis was devided into three clinical presentations: distal type (20 cases), lateral type (19 cases), and multiple type (6 cases). RESULTS: In the groups of distal and multiple type of streak type onychomycosis, the longitudinal nail furrows were deep compared to the groups of non-streak type onychomycosis and normal control (p< 0.05). In the group of distal type of streak type onychomycosis, the tinea pedis severities were low compared to the group of non-streak type onychomycosis (p< 0.05). There was no statistically significant difference when comparing the nail growth rate of the groups of streak type onychomycosis, non-streak type onychomycosis, and normal control (p> 0.05). In the groups of distal and lateral type of streak type onychomycosis, the treatment responses were poor compared to the group of non-streak type onychomycosis (p< 0.05). CONCLUSION: Treatment response is poor in streak type onychomycosis, therefore, extra treatments in addition to oral antifungal agents should be considered. If the patients who have deep longitudinal nail furrow are affected with tinea pedis, effective therapies in early stage should be considered to prevent to progress to streak type onychomycosis.