Onychomycosis in immunocompromised population: Phenotypic and molecular identification.
diabetes mellitus
lupus nephritis
onychomycosis
transplantation
Journal
Mycoses
ISSN: 1439-0507
Titre abrégé: Mycoses
Pays: Germany
ID NLM: 8805008
Informations de publication
Date de publication:
Nov 2023
Nov 2023
Historique:
revised:
30
06
2023
received:
05
06
2023
accepted:
16
07
2023
medline:
4
10
2023
pubmed:
25
7
2023
entrez:
24
7
2023
Statut:
ppublish
Résumé
Onychomycosis is common among immunosuppressed individuals. Renal transplant recipients (RTR) and lupus nephritis (LN) patients are submitted to corticosteroid and other immunosuppressive therapy; and diabetes mellitus (DM) patients are intrinsically immunocompromised. The aim of this study was to characterise and identify fungal infections on the nails (feet and hands) in immunocompromised patients. The clinical material, nail scales (foot and/or hand), was collected from 47 RTR, 66 LN, 67 DM, and 78 immunocompetent individuals (control group). Phenotypic and molecular analyses were performed. A total of 258 patients were examined. There was a female predominance, except in the RTR. The average age was 52 years old. Lateral distal subungual onychomycosis (OSDL) (75.2%), mainly affecting the hallux nail, was frequent. The predominance of dermatophyte on toenails and Candida species on fingernails was statistically significant. A higher frequency of fingernail involvement in LN and DM, and for LN, the difference was significant (p = .0456). Infections by Candida spp. were more frequent in DM. Using molecular methods, 87.2% of diagnoses were confirmed, identifying fungal agents at the species level. Dermatophytes, Trichophyton rubrum and Trichophyton interdigitale and the species of Candida, C. parapsilosis and C. albicans, were the most frequent fungal agents. Molecular techniques (sequencing of ITS regions of rDNA) offer greater accuracy, although there is no difference, regarding the detection. Clinical presentation and fungal species may differ somewhat from the general population. Immunosuppression did not increase fungal detection positivity.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1018-1024Subventions
Organisme : Funadersp
Informations de copyright
© 2023 Wiley-VCH GmbH. Published by John Wiley & Sons Ltd.
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