A Clinical Study of Onychomycosis

Park, Jang Kyu; Kwon, Kyung Sool; Yu, Hee Joon

Abstract

Onychomycosis is not uncommon among nail diseases. A review of the reports between 1985 and December 2004 found it to be increasing (0.86%) until 1988 among the outpatients in the department of dermatology, but it decreased thereafter to the current average of 0.48% (0.43~0.53%). No difference was found in the occurrence between the genders. It was most frequently seen in patients aged 40~49 (22%) followed by those aged 50~59 (19.6%), 30~39 (19.3%) and 20~29 (13.6%) respectively, although some discrepancies were shown among the investigators. A new classification of onychomycosis was reported by Baran et al in 1998, approximately 25 years after the first classification of four types published by Zaias in 1972. They suggested onychomycosis should be categorized into five clinical types: distal and lateral (DLSO), superficial, proximal subungual (PSO), endonyx, and total dystrophic (TDO). The basis of the new classification was the pattern of nail plate involvement by mode and site invasion, rather than fungal etiology; therefore, Candida onychomycosis is not a separate category in the new classification. Nail growth rate can be an important factor that determines the initiation of the infection, the treatment periods or results in onychomycosis. It depends mainly on the turnover rate of the nail matrix cells, but is influenced by numerous environmental, physiological, and pathological factors.