Fungal infection of the nails is an increasingly recognized disease in infants and children. However, it can be difficult to distinguish clinically from other nail dystrophies. In addition, many mistakenly believe that onychomycosis does not occur in childhood. Under-recognition of this infectious disorder therefore occurs. Although many consider "nail fungus" a trivial cosmetic concern, it can lead to discomfort, risk of secondary infection, and a more significant health threat in immunocompromised or diabetic individuals. It should always be considered in the differential diagnosis of nail plate disorders in children as it is one of the more common causes.
Here we review the latest data on prevalence of the disease, reasons for its relatively low incidence compared with adults, and important predisposing factors. It is important to confirm the clinical diagnosis of onychomycosis in children, and affected individuals should be examined for concomitant tinea pedis. As familial disease often occurs, it is important to check parents and siblings as well for onychomycosis and tinea pedis.
Treatment of onychomycosis is challenging, and recurrence appears to be more common in children than in adults. Prolonged systemic antifungal therapy is commonly required. However, pediatric practitioners and parents alike hesitate when asked to treat young children with a systemic drug that requires laboratory monitoring and can have systemic toxicities. Due to their thinner, faster-growing nails, children are theoretically more likely to respond to topical monotherapy than adults, and therefore good candidates for topical antifungal therapy.
The clinical data on the use of topical antifungals in pediatric onychomycosis is scarce. We review data that exist from case reports and small clinical trials. New topical antifungals are now available that afford better nail penetration and additional delivery routes to the site of infection. Pediatric trials are now on-going, and should clarify the usefulness of these agents in children.
Download full-text PDF |
Source |
|---|
Publication Analysis
Top Keywords
Similar Publications
Retrospective Epidemiology of Dermatomycosis in Kinshasa, Democratic Republic of Congo, From 2000 to 2023.
Mycoses
December 2024
Working Group on Mycoses in DRC, Kinshasa, Democratic Republic of the Congo.
Background: Although cutaneous mycoses are a global public health problem, very few data are available in the Democratic Republic of Congo (DRC).
Objectives: This study aimed to describe the retrospective clinical epidemiology of dermatomycosis and their associated risk factors in dermatological consultations in Kinshasa, DRC.
Methods: A retrospective study based on the medical records of patients seen in the departments of dermatology of 2 major hospitals in Kinshasa from March 2000 to August 2023 was carried out.
Onychomycosis in the US Pediatric Population-An Emphasis on Fusarium Onychomycosis.
Pediatr Dermatol
October 2024
Bako Diagnostics, Alpharetta, Georgia, USA.
Article Synopsis
- Onychomycosis, a common nail fungus, is challenging to treat and often reoccurs, particularly in pediatric patients.
- A study analyzed 19,770 pediatric patients over 9 years, confirming that onychomycosis occurred in 37% of cases, with higher rates in younger age groups (6-11 years) and predominantly caused by dermatophytes like Trichophyton rubrum.
- The findings indicate that elementary school-aged children are at a higher risk due to factors such as puberty-related sweat production and footwear choices, highlighting the growing prevalence of Fusarium infections that may require adjusted treatment approaches.
Efinaconazole 10% solution: a comprehensive review of its use in the treatment of onychomycosis.
Expert Opin Pharmacother
October 2024
Mediprobe Research Inc, London, ON, Canada.
Article Synopsis
- Onychomycosis is a fungal infection affecting nails, and while oral antifungals are the main treatment for severe cases, the topical solution efinaconazole (10%) is effective and safe for mild to moderate infections, approved for ages 6 and up.
- The literature review highlights efinaconazole's pharmacokinetics, safety, and effectiveness across different populations, including children, diabetics, and the elderly, showing no systemic side effects or drug interactions.
- Efinaconazole is particularly beneficial for certain groups, such as females, children, early-stage infections, and those with mild nail involvement, making it a viable option, especially in cases of terbinafine resistance.
Reactive oxygen species-inducing itraconazole and its anti-biofilm activity against resistant Candida parapsilosis sensu lato biofilm cells isolated from patients with recalcitrant onychomycosis.
Arch Dermatol Res
September 2024
Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Article Synopsis
- Candida parapsilosis is a major fungus contributing to nail infections, known for forming biofilms that resist standard antifungal treatments.
- This research focused on evaluating the effectiveness of the antifungal drug itraconazole against biofilms of C. parapsilosis, examining its ability to induce reactive oxygen species (ROS) that lead to cell death.
- The findings suggest that targeting ROS can enhance the effectiveness of antifungal therapy, particularly for stubborn cases of nail fungus, highlighting the potential of itraconazole as a key treatment option.
Pediatric dermatophyte onychomycosis: a review.
Int J Dermatol
September 2024
Mediprobe Research Inc., London, ON, Canada.
Article Synopsis
- * Antifungal treatments like systemic itraconazole and terbinafine show high cure rates and minimal side effects, but the limited and outdated studies reduce their reliability; topical treatments have lower cure rates but are supported by larger clinical trials.
- * Children with weakened immune systems are at higher risk and require tailored treatment; maintaining good hygiene and early intervention are essential for preventing and reducing the spread of the infection.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!