Skip to main content
SpringerLink
Log in

Toenail Onychomycosis in a Portuguese Geriatric Population

  • Published:
Mycopathologia Aims and scope Submit manuscript

Abstract

Onychomycosis is a common fungal infection of the nail but few data of mycological features in geriatric Portuguese population are yet available. The aim of this study was to perform a mycological examination and characterization of fungal nail pattern of a geriatric population from the north of Portugal clinically suspected of onychomycosis. A total of 108 patients attending the Podology Service in the Centro Hospitalar do Alto Ave (Portugal) from October 2007 to January 2009 were enrolled. All were suspected of having onychomycosis by the abnormal appearance of their nails. From these, 59.3% were diabetic. Distal and lateral subungual onychomycosis was the more common clinical pattern followed by total dystrophic onychomycosis. In 21.3% cases, every nail in both feet had an abnormal appearance. In 86%, the hallux was involved in at least one foot. Fifty samples were culture positive, and fifty-four isolates were reported regardless of the questionable pathogenicity of the infectious agent. In three cases, clinical feature of the nail, direct microscopy, and culture were consistent with Scopulariopsis infection. Fusarium spp. were identified in three cases; however, only one isolate was preceded by the observation of branching septate filaments by direct microscopy. No mixed infections with dermatophytes were reported. Trichophyton rubrum was the dermatophyte most frequently isolated (83.3%) followed by Trichophyton interdigitale. In Portugal, onychomycosis is still viewed by general population as a cosmetic condition. Health risk is enhanced in geriatrics that only perceived the severity of their condition when experiencing further foot complications that include bacterial infection and pain.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Midgley G, Moore MK. Onychomycosis. Rev Iberoam Micol. 1998;15:113–7.

    PubMed  CAS  Google Scholar 

  2. Roberts DT. Prevalence of dermatophyte onychomycosis in the United Kingdom: results of an omnibus survey. Br J Dermatol. 1992;126((S39)):23–7.

    Article  PubMed  Google Scholar 

  3. Perea S, Ramos MJ, Garau M, Gonzalez A, Noriega AR, del Palacio A. Prevalence and risk factors of tinea unguium and tinea pedis in the general population in Spain. J Clin Microbiol. 2000;38:3226–30.

    PubMed  CAS  Google Scholar 

  4. Sigurgeirsson B, Steingrímsson O, Sveinsdóttir S. Prevalence of onychomycosis in Iceland: a population-based study. Acta Derm Venereol. 2002;82:467–9.

    Article  PubMed  Google Scholar 

  5. Burzykowski T, Molenberghs G, Abeck D, Haneke E, Hay R, Katsambas A, et al. High prevalence of foot diseases in Europe: results of the Achilles Project. Mycoses. 2003;46:496–500.

    Article  PubMed  CAS  Google Scholar 

  6. Elewski BE. Onychomycosis: pathogenesis, diagnosis and management. Clin Microbiol Rev. 1998;11:415–29.

    PubMed  CAS  Google Scholar 

  7. Tosti A, Hay R, Arenas-Guzmán R. Patients at risk of onychomycosis: risk factor identification and active prevention. Eur Acad Dermatol Venereol. 2005;19((S1)):13–6.

    Article  Google Scholar 

  8. Jaffe R. Onychomycosis: recognition, diagnosis, and management. Arch Fam Med. 1998;7:587–92.

    Article  PubMed  CAS  Google Scholar 

  9. Torres-Rodríguez JM, López-Jodra O. Epidemiology of nail infection due to keratinophilic fungi. Rev Iberoam Micol. 2000;17:1–12.

    Google Scholar 

  10. Drake LA, Scher RK, Smith EB, Faich GA, Smith SL, Hong JJ, et al. Effect of onychomycosis on quality of life. J Am Acad Dermatol. 1998;38:702–4.

    Article  PubMed  CAS  Google Scholar 

  11. Drake LA, Patrick DL, Fleckman P, André J, Baran R, Haneke E, et al. The impact of onychomycosis on quality of life: development of an international onychomycosis-specific questionnaire to measure patient quality of life. J Am Acad Dermatol. 1999;41:189–96.

    Article  PubMed  CAS  Google Scholar 

  12. Lubeck DP. Measuring health-related quality of life in onychomycosis. J Am Acad Dermatol. 1998;38((Part3)):S64–6.

    Article  PubMed  CAS  Google Scholar 

  13. Mayser P, Freund V, Budihardja D. Toenail onychomycosis in diabetic patients: issues and management. Am J Clin Dermatol. 2009;10:211–20.

    Article  PubMed  Google Scholar 

  14. Rich P. Onychomycosis and tinea pedis in patients with diabetes. J Am Acad Dermatol. 2000;43:S130–4.

    Article  PubMed  CAS  Google Scholar 

  15. Scher RK, Tavakkol A, Sigurgeirsson B, Hay RJ, Joseph WS, Tosti A, et al. Onichomycosis: diagnosis and definition of cure. J Am Acad Dermatol. 2007;56:939–44.

    Article  PubMed  Google Scholar 

  16. de Berker D. Fungal nail disease. N Engl J Med. 2009;360:2108–16.

    Article  PubMed  Google Scholar 

  17. Baran R, Hay RJ, Tosti A, Haneke E. A new classification of onychomycosis. Br J Dermatol. 1998;139:567–77.

    Article  PubMed  CAS  Google Scholar 

  18. de Araújo AJG, Bastos OM, Souza MAJ, Oliveira JC. Ocorrência de onicomicose em pacientes atendidos em consultórios dermatológicos da cidade do Rio de Janeiro, Brasil. Ann Bras Dermatol. 2003;78:299–308.

    Google Scholar 

  19. Szepietowski JC, Reich A, Garlowska E, Kulig M, Baran E. Factors influencing coexistence of toenail onychomycosis with tinea pedis and other dermatomycoses. Arch Dermatol. 2006;142:1279–84.

    Article  PubMed  Google Scholar 

  20. Saunte DM, Holgersen JB, Haedersdal M, Strauss G, Bitsch M, Svendsen OL, et al. Prevalence of toe nail onychomycosis in diabetic patients. Acta Derm Venereol. 2006;86:425–8.

    Article  PubMed  Google Scholar 

  21. Robert R, Pihet M. Conventional methods for the diagnosis of dermatophytosis. Mycopathologia. 2008;166:295–306.

    Article  PubMed  Google Scholar 

  22. Feuillade de Chauvin M. New diagnostic techniques. Eur Acad Dermatol Venereol. 2005;19((S1)):20–4.

    Article  Google Scholar 

  23. Hay R. Literature review. Eur Acad Dermatol Venereol. 2005;19((S1)):1–7.

    Article  Google Scholar 

  24. Roberts DT, Taylor WD, Boyle J. Guidelines for treatment of onychomycosis. Br J Dermatol. 2003;148:402–10.

    Article  PubMed  CAS  Google Scholar 

  25. Effendy I, Lecha M, Feuilhade de Chauvin M, Di Chiacchio N, Baran R. Epidemiology and clinical classification of onychomycosis. J Eur Acad Dermatol Venereol. 2005;19((S1)):8–12.

    Article  PubMed  Google Scholar 

  26. Seebacher C, Brasch J, Abeck D, Cornely O, Effendy I, Ginter-Hanselmayer G, et al. Onychomychosis. Mycoses. 2007;50:321–7.

    Article  PubMed  CAS  Google Scholar 

  27. Seebacher C, Bouchara JP, Mignon B. Updates on the epidemiology of dermatophyte infections. Mycopathologia. 2008;166:335–52.

    Article  PubMed  Google Scholar 

  28. Valdigen GL, Pereira T, Macedo C, Duarte ML, Oliveira P, Ludovico P, et al. A twenty-year survey of dermatophytosis in Braga, Portugal. Int J Dermatol. 2006;45:822–7.

    Article  Google Scholar 

  29. English MP. Nails and fungi. Br J Dermatol. 1976;94:697–701.

    Article  PubMed  CAS  Google Scholar 

  30. Arrese JE, Piérard-Franchimont C, Piérard GE. Facing up to the diagnostic uncertainty and management of onychomycoses. Int J Dermatol. 1999;38((S2)):1–6.

    Article  PubMed  Google Scholar 

  31. Summerbell RC, Cooper E, Bunn U, Jamieson F, Gupta AK. Onychomycosis: a critical study of techniques and criteria for confirming the etiologic significance of nondermatophytes. Med Mycol. 2005;43:39–59.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. (IBB) Institute for Biotechnology and Bioengineering, Centre for Biological Engineering, Universidade do Minho, Campus de Gualtar, 4710-057, Braga, Portugal

    N. Dias, C. Santos & N. Lima

  2. (CITS) Centro de Investigação em Tecnologias da Saúde, R. Central de Gandra, 4585-116, Gandra (Paredes), Portugal

    N. Dias & M. Portela

Authors
  1. N. Dias
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C. Santos
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Portela
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. N. Lima
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to N. Dias.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dias, N., Santos, C., Portela, M. et al. Toenail Onychomycosis in a Portuguese Geriatric Population. Mycopathologia 172, 55–61 (2011). https://doi.org/10.1007/s11046-011-9402-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11046-011-9402-1

Keywords

Search

Navigation