Affiliation:
1. Dermatology Unit IRCCS Azienda Ospedaliero‐Universitaria di Bologna Bologna Italy
2. Department of Medical and Surgical Sciences Alma Mater Studiorum, University of Bologna Bologna Italy
3. Dermatology Unit, Department of Medicine University of Padova Padova Italy
4. Dermatology Unit San Bortolo Hospital Vicenza Italy
5. Private Dermatology Practice Lugano Switzerland
6. Faculdade de Medicina do ABC Hospital do Servidor Público Municipal de São Paulo São Paulo Brazil
7. Head of Dermatology Clinic – Hospital do Servidor Público Municipal de São Paulo São Paulo Brazil
Abstract
AbstractBackgroundTrichophyton rubrum and Trichophyton mentagrophytes variant interdigitalis are the most frequent etiologic agents of onychomycosis. Diagnosis of certainty requires mycological examination, which often results unfeasible.ObjectivesThe aim of our study is to describe pathogen specific dermoscopic features, allowing a differential diagnosis without the need for cultural examination, in order to prescribe the most appropriate treatment anyway.Patients and methodsWe conducted an observational retrospective study on 54 patients with a culture proven diagnosis of distal subungual onychomycosis of the toenail, caused by Trichophyton rubrum or Trichophyton mentagrophytes variant interdigitalis. Using a videodermatoscope we collected data on nail colour (white, yellow, orange, brown, dark) and on dermoscopic patterns (aurora, spikes, jagged, ruin, linear edge, dots, striae).ResultsFifty‐four patients, with a total of 72 nails, were eligible for this study. Analysing the association between discoloration of the nail plate and type of infection (T. rubrum or T. interdigitalis), no correlation turned out to be statistically significant. Instead, significant associations between spikes and T. rubrum infection and striae and infection from T. interdigitalis were identified. Finally, a 100% specificity was identified for white colour and ruin pattern for T. rubrum infection, and brown colour, jagged border and aurora pattern for T. interdigitalis.ConclusionsTrying to find relationships between specific pathogens and dermoscopic patterns, we found out an association between spikes and striae and T. rubrum and T. interdigitalis respectively. Further larger studies are however necessary to evaluate our preliminary findings.
Subject
Infectious Diseases,Dermatology,General Medicine
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