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Literature review. Onychomycosis
1The Faculty of Medicine and Health Sciences, Queen's University Belfast, Whitla Medical Building, 97 Lisburn Road, Belfast BT9 7BL, UK. r.hay@qub.ac.uk
Summary
Onychomycosis, a common nail fungal infection, affects up to 26.9% of people. Diagnosis relies on mycological tests, but newer methods like calcofluor and RFLP offer improved accuracy for identifying fungal species and treatment outcomes.
Area of Science:
- Medical Mycology
- Dermatology
- Infectious Diseases
Background:
- Onychomycosis, a prevalent nail fungal infection, presents classification challenges due to potential alternative fungal penetration routes.
- Prevalence estimates indicate onychomycosis affects a significant portion of the population, with dermatophytes being the primary global cause.
- Current diagnostic methods, primarily mycological examination, are limited by a substantial false-negative rate.
Purpose of the Study:
- To review the current understanding of onychomycosis, including classification, prevalence, causative agents, and diagnostic challenges.
- To highlight emerging diagnostic techniques and their potential to improve accuracy in identifying fungal nail infections.
- To summarize treatment strategies, including monotherapy and combination approaches for onychomycosis.
Main Methods:
- Review of existing literature on onychomycosis epidemiology, etiology, and clinical presentation.
- Discussion of traditional mycological diagnostic methods and their limitations.
- Exploration of novel diagnostic tools such as calcofluor staining and molecular genetic techniques like Restriction Fragment Length Polymorphism (RFLP).
Main Results:
- Onychomycosis prevalence can be as high as 26.9%, with dermatophytes being the most common etiological agents worldwide.
- Mycological examination has a significant false-negative rate (30%), necessitating complementary diagnostic aids.
- Newer techniques like calcofluor and RFLP show promise for accurate fungal identification and differentiating treatment failure from reinfection.
Conclusions:
- Accurate diagnosis of onychomycosis is crucial, and advanced methods are improving species identification and treatment monitoring.
- Combination therapy may offer superior efficacy compared to monotherapy for treating onychomycosis.
- Continued research into diagnostic and therapeutic strategies is essential for managing this widespread fungal infection.