KMID : 0670820130180020021
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Korean Journal of Medical Mycology 2013 Volume.18 No. 2 p.21 ~ p.29
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A Clinico-mycological Study of Onychomycosis with Dermatophytoma
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Lee Myung-Hoon
Suh Moo-Kyu Ha Gyoung-Yim
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Abstract
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Background: Although there have been many studies about onychomycosis, the study about onychomycosis with dermatophytoma has not been reported yet in Korea.
Objective: The purpose of this study was to investigate the clinical characterictics and treatment strategies of the onychomycosis with dermatophytoma compare with the other onychomycosis.
Methods: In the 5-year period 2007-2011, we reviewed forty five patients with toenail onychomycosis
with dermatophytoma, proven by direct potassium hydroxide examination. The etiological agents were identified by cultures on Sabouraud¡¯s dextrose agar with and without cycloheximide. To confirm dermatophytoma, we performed histopathologic evaluation of the nail plate by nail clipping. Results: Toenail onychomycosis with dermatophytoma were 2.9% of all onychomycosis. Among the age groups, the incidence rate was highest in the sixties (24.4%). The ratio of male to female patients was 1:1.1. The frequency of associated disease was highest in diabetes mellitus (17.7%). The right great toenail was most common affected nails. Distal and lateral subungual onychomycosis (88.9%) was the most common clinical type. The round lesion was most common clinical features of affected area (66.7%), followed by linear lesion (33.3%). Trichophyton rubrum was most common etiological agent (57.8%). The partial removal of the tonail combined with oral and topical antifungal agent was most common in treatment of onychomycosis with dermatophytoma.
Conclusion: Because of the increase in onychomycosis with dermatophytoma, and its relative resistance to the conventional treatment of onychomycosis, we suggest the need of a careful mycological examination to diagnose the dermatohpytoma in patients with onychomycosis, and we also propose more aggressive treatment strategy is required to treat dermatophytoma.
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KEYWORD
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Dermatophytoma, Onychomycosis
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