Ann Dermatol.  2013 Aug;25(3):327-334. 10.5021/ad.2013.25.3.327.

Onychomycosis in Children: An Experience of 59 Cases

• Kim DM
• Suh MK
• Ha GY

• KMID: 2265873
• DOI: http://doi.org/10.5021/ad.2013.25.3.327

Abstract

BACKGROUND
Although tinea unguium in children has been studied in the past, no specific etiological agents of onychomycosis in children has been reported in Korea.
OBJECTIVE
The purpose of this study was to investigate onychomycosis in Korean children.
METHODS
We reviewed fifty nine patients with onychomycosis in children (0~18 years of age) who presented during the ten-year period between 1999 and 2009. Etiological agents were identified by cultures on Sabouraud's dextrose agar with and without cycloheximide. An isolated colony of yeasts was considered as pathogens if the same fungal element was identified at initial direct microscopy and in specimen-yielding cultures at a follow-up visit.
RESULTS
Onychomycosis in children represented 2.3% of all onychomycosis. Of the 59 pediatric patients with onychomycosis, 66.1% had toenail onychomycosis with the rest (33.9%) having fingernail onychomycosis. The male-to-female ratio was 1.95:1. Fourteen (23.7%) children had concomitant tinea pedis infection, and tinea pedis or onychomycosis was also found in eight of the parents (13.6%). Distal and lateral subungual onychomycosis was the most common (62.7%) clinical type. In toenails, Trichophyton rubrum was the most common etiological agent (51.3%), followed by Candida albicans (10.2%), C. parapsilosis (5.1%), C. tropicalis (2.6%), and C. guilliermondii (2.6%). In fingernails, C. albicans was the most common isolated pathogen (50.0%), followed by T. rubrum (10.0%), C. parapsilosis (10.0%), and C. glabrata (5.0%).
CONCLUSION
Because of the increase in pediatric onychomycosis, we suggest the need for a careful mycological examination of children who are diagnosed with onychomycosis.

Keyword

Child; Onychomycosis

MeSH Terms

Agar
Candida albicans
Child
Cycloheximide
Follow-Up Studies
Glucose
Humans
Microscopy
Nails
Onychomycosis
Parents
Tinea Pedis
Trichophyton
Yeasts
Agar
Cycloheximide
Glucose

Figure

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  Fig. 1 Distal and lateral subungual onychomycosis due to Trichophyton rubrum in a 3-year-old boy. Yellowish discoloration with subungual hyperkeratosis on the right distal great toenail.

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  Fig. 2 Superficial white onychomycosis due to Trichophyton rubrum in a 3-year-old girl. Small, white, friable patches are spread on the right great toenail surface.

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  Fig. 3 Annual incidence of patients with onychomycosis in children.

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  Fig. 4 Monthly distribution of patients with onychomycosis in children.

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  Fig. 5 Sex distribution of patients with onychomycosis in children.

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  Fig. 6 Residence of patients with onychomycosis in children.

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