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Onychomycosis in children: prevalence and management
A K Gupta1, P Chang, J Q Del Rosso
1Sunnybrook Health Science Center, Division of Dermatology, University of Toronto, Ontario, Canada. agupta@execulink.com
Insights
Onychomycosis in children, a fungal nail infection, often presents with athlete's foot. New oral antifungal medications show promise for effective and safe treatment in pediatric cases.
Area of Science:
- Dermatology
- Mycology
- Pediatrics
Background:
- Onychomycosis, a fungal nail infection, is less common in children than adults, necessitating accurate diagnosis.
- Distal and lateral subungual onychomycosis is the most frequent clinical presentation.
- Trichophyton rubrum is the predominant causative agent in North America.
Purpose of the Study:
- To review the efficacy and safety of newer oral antifungal agents for treating onychomycosis in children.
- To assess the role of oral antifungals in managing pediatric onychomycosis, particularly moderate to severe cases.
Main Methods:
- Literature review of studies on oral antifungal therapy for pediatric onychomycosis.
- Analysis of data on the effectiveness and safety of itraconazole, terbinafine, and fluconazole in children.
Main Results:
- Newer oral antifungal agents (itraconazole, terbinafine, fluconazole) are increasingly utilized.
- These agents demonstrate effectiveness and safety in treating pediatric onychomycosis.
- Shorter treatment durations may improve patient compliance.
Conclusions:
- Oral antifungal agents are valuable in managing pediatric onychomycosis.
- Further clinical experience will refine treatment strategies for children.
- Accurate diagnosis is crucial due to the lower prevalence in pediatric populations.
Abstract:
Onychomycosis in children is often accompanied by tinea pedis and a family history of onychomycosis. The prevalence of onychomycosis in children is substantially lower than that of adults; therefore it is important to confirm the clinical diagnosis. The most common presentation of onychomycosis is the distal and lateral subungual type. The organism most commonly isolated in North America is Trichophyton rubrum. Oral antifungal therapy is required, especially when the onychomycosis is of moderate to severe intensity, with nail matrix involvement. The new oral antifungal agents itraconazole, terbinafine, and fluconazole are being increasingly used for the treatment of onychomycosis. Review of the literature suggests that these agents are effective and safe in managing onychomycosis in children. The short duration of therapy required with these drugs should help improve compliance. The data suggest that the new oral antifungal agents have a role in the treatment of onychomycosis in children. Further experience will help us better position these drugs when evaluating the management of onychomycosis in children.