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Causative pathogens in onychomycosis and the possibility of treatment resistance: a review

E G Evans1

  • 1Mycology Reference Laboratory, University of Leeds, UK.

Journal of the American Academy of Dermatology
|May 22, 1998
PubMed

Insights

Onychomycosis, a fungal nail infection, is often caused by dermatophytes, but Candida and molds also play roles. Identifying the specific pathogen is crucial for effective antifungal treatment, especially with emerging drug resistance.

Area of Science:

  • Mycology
  • Dermatology
  • Infectious Diseases

Background:

  • Onychomycosis is a common nail infection.
  • Dermatophytes, particularly Trichophyton rubrum, are the most frequent causative agents.
  • The roles of Candida species and nondermatophytic molds in onychomycosis are not fully understood.

Purpose of the Study:

  • To highlight the importance of accurate pathogen identification in onychomycosis.
  • To discuss the potential impact of azole antifungal resistance on treatment strategies.

Main Methods:

  • Review of current etiological agents of onychomycosis.
  • Consideration of emerging antifungal resistance patterns.

Main Results:

  • Dermatophytes are the primary cause of onychomycosis.
  • The pathogenicity of Candida and molds requires further investigation.
  • Increased resistance in Candida species, including Candida albicans, C. glabrata, and C. krusei, to fluconazole has been observed.

Conclusions:

  • Accurate identification of fungal pathogens is essential for effective onychomycosis treatment.
  • Emerging azole resistance in Candida species may influence the management of onychomycosis.

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