Onychomycosis in Israel: epidemiological aspects

Area of Science:

• Medical Mycology
• Epidemiology
• Dermatology

Background:

• Onychomycosis is a prevalent fungal nail infection often requiring prolonged oral treatment.
• Causative agents (Dermatophytes, Candida, non-dermatophyte moulds) and their prevalence vary globally.
• Understanding local epidemiology is crucial for effective onychomycosis management.

Purpose of the Study:

• To investigate the epidemiological parameters of onychomycosis in Israel.
• To identify the primary fungal aetiologies and their distribution in toe and fingernails.
• To analyze associations between onychomycosis and demographic factors like gender and age.

Main Methods:

• Retrospective analysis of data from 27,093 patients across six Israeli centers over 2 and 10-year periods.
• Diagnosis confirmed via KOH/calcofluor microscopy and fungal culture isolation from nail scrapings.
• Statistical analysis using SPSS v18, examining fungal aetiology, gender, and age group associations.

Main Results:

• Dermatophytes were the predominant aetiology, with Trichophyton rubrum being the most frequent isolate.
• Candida species, particularly C. parapsilosis, were more common in women's fingernails and increased with age.
• Non-dermatophyte moulds (NDMs) showed a low isolation rate, with Aspergillus terreus as the most common NDM.

Conclusions:

• This large-scale cohort study provides key epidemiological insights into onychomycosis in Israel.
• Dermatophytes are the primary cause, but Candida and NDMs play roles, especially in specific demographics.
• Findings support the need for tailored diagnostic and treatment strategies based on local epidemiological data.