Abstract
Since the early 20th century, onychomycosis originated with the onset of war, the use of occlusive footwear, and the mass migration of people by transportation in the United States. Even though onychomycosis has a high prevalence in the US, other parts of the world including Canada, West Africa, Southeast Asia, Northern Australia, and Europe have been well documented with cases of fungal toenail infection in their environments. Trichophyton rubrum (T. rubrum) is the major dermatophyte responsible for toenail fungal infection and is typically diagnosed in conjunction with tinea pedis, especially in individuals older than 60 years. Gender roles, age, cultural habits, shoe gear, sports activities, and genetic predisposition all contribute to the different presentation of onychomycosis in these areas where organisms like dermatophytes, candida, and molds were isolated in a variety of cases. Despite the differences in isolated pathogens, treatment outcomes remained consistent. This literature review discusses the influence of tinea pedis, genetics, shoe gear, sports, and age on the development of onychomycosis.
Highlights
Onychomycosis is a fungal infection of the toenails or fingernails that may involve any component of the nail unit
Trichophyton rubrum (T. rubrum) is the most prevalent pathogen, and an increased incidence of this dermatophyte was observed in toenail onychomycosis
The prevalence of onychomycosis of the toenails is highly associated with superficial fungal infections of the skin such as tinea pedis
Summary
Onychomycosis is a fungal infection of the toenails or fingernails that may involve any component of the nail unit. Prevalence is increasing in Western countries and is highest in individuals more than 65 years of age [1] It is often found in conjunction with tinea pedis and sometimes one infection can increase the risk of the other infection [2]. In 2014, Tosti et al [3] conducted a prospective study of 1655 patients, aged 18 to 70 years, with onychomycosis and found that patients with onychomycosis for >10 years have more psychosocially than physically impaired health-related quality of life (QoL). Of these patients, the greatest psychosocial ramification was directly related to the number of toenails involved
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