What Are Treatment Options for Pediatric Onycomycosis?

Discussion Onycomycosis is a fungal infection of the nails. It has a world-wide prevalence of 0.3% with some geographical variations such as in the U.S. it is 0.44%. It is an uncommon problem especially in children. It is very uncommon in those under 6 years and only very sporadic case reports in those under 2 years. The lower incidence is felt to be due to children’s faster nail growth, smaller surface to infect, reduced exposure to fungi, lower prevalence of tinea pedis and especially less cumulative trauma. Onycomycosis is more common in families (unsure if this is due to genetic factors or family members having more onycomycosis and therefore increased environmental exposure), people with immunodeficiencies (especially adult diabetic patients or HIV), and people with Down’s syndrome. Trauma is a major predisposing factor as is hyperhidrosis. Clinical presentation includes color changes of the nail plate (often yellowish), debris under the nail bed, hyperkeratosis and thickening of the nail, and onycholysis. Family members should also be checked for onycomycosis and tinea pedis. Distal and lateral subungual onycomycosis is the most common. Dermatophytes especially are the usual cause especially Trichophyton rubrum but other causes include Candida sp. and nondermatophyte species such as Aspergillus. Learning Point Onycomycosis is difficult to treat and can recur. Systemic medications (often prolonged) are often the mainstay, but topical medications are also bein...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news