Candida Onychomycosis Research Articles

Formulation and evaluation of herbal essential oil based nail lacquer for management of onychomycosis

IntroductionOnychomycosis (Paronychia) is a common fungal nail infection, characterised by thickened, discoloured and brittle nails often accompanied by pain and discomfort. It is one of the most prevalent fungal nail infections with the global incidence of >20 % affected commonly by Candida albicans and Candida parapsilosis. The market today is flooded with various antifungal therapies (Azoles, Imidazoles, Allylamines, etc.) but their clinical applicability is limited due to associated side effects. The study is an attempt to formulate essential oil-based nail lacquer against Candidal Onychomycosis. Material and MethodSelection of essential oils and preparation of their blends (EOB) was made on basis of their antifungal activity (minimum inhibitory concentration; MIC and zone of inhibition; ZOI) and physiological effect they exhibit on varied pathological parameters of onychomycosis. Simultaneously, varied batches of nail lacquer (N1-N5) were prepared by varying the concentrations of polymer and film forming agent and were evaluated for their formulatory characteristics (drying time, incidence of white patches, film texture, etc.). Optimal nail lacquer batch was loaded with screened EOB and was evaluated for various characteristics and antifungal activity. ResultThe formulation F4 was found to form a smooth, transparent film over the nail with absence of any tackiness or white patches. Moreover, F4 formulation exhibited minimum MIC among varied batches and higher ZOI (4.3 cm) as compared to marketed preparation (3.5 cm), indicating better antifungal activity. ConclusionEssential oils, as an active agent, could prove to be a natural, safer, and more effective alternative to the conventionally available topical preparations for the management of fungal infections. The development of this herbal mixture opens up new possibilities for treating onychomycosis, necessitating additional research and clinical studies to establish its clinical safety, efficacy, and viability.

Lesson from nature: Zataria multiflora nanostructured lipid carrier topical gel formulation against Candida-associated onychomycosis, a randomized double-blind placebo-controlled clinical trial

PurposeThe increasing resistance to onychomycosis treatment globally is a major concern as it results in treatment failures. This research aimed to investigate the effectiveness of incorporating nanostructured lipid carriers (NLCs) in a gel formulation for treating mild to moderate Candida-associated onychomycosis using Zataria multiflora (Zt) essential oils. MethodsThe characteristics of Zataria multiflora-loaded nanostructured lipid carriers (Zt-NLCs) were validated using a carbopol gel (1 % w/w). In vitro tests were conducted using CLSI M60 standards to evaluate the susceptibility of ten commonly encountered dermatophyte species to antifungal agents. A clinical study was conducted involving 40 volunteers randomly assigned to two groups: one receiving the Zt-NLCs gel and the other receiving a placebo, using a double-blind, placebo-controlled design. The objective was to assess clinical manifestations and mycological findings after topical application for 2 and 4 weeks. The causative agents' species were identified using a PCR-RFLP method. ResultsThe preparation of Zt-NLCs gel resulted in a uniform suspension of spherical nanoparticles with favourable characteristics and no cytotoxic effects. Zt-NLCs demonstrated significant inhibitory effects on fungal growth and effectively improved clinical and mycological criteria in comparison to the placebo group (p < 0.005), even after 2 weeks of treatment. The C. albicans complex was recognized as the predominant species isolated from the patients using PCR-RFLP. ConclusionThe administration of Zt-NLCs gel for two weeks showed significant efficacy in disease management, as reported by both dermatologists and mycologists and therefore shows its potential use as a treatment against Candidal onychomycosis.

Species distribution and antifungal susceptibility profiles of yeasts isolated from onychomycosis: a cross-sectional study with insights into emerging species.

Candida onychomycosis is a common fungal infection affecting the nails, primarily caused by Candida (C.) species. Regarding the increasing trend of Candida onychomycosis and the antifungal resistant phenomenon in recent years, this study aims to evaluate the epidemiological characteristics of Candida onychomycosis, the distribution of emerging species, and the antifungal susceptibility profiles of isolates. Onychomycosis caused by yeast species was confirmed through direct examination and culture of nail scraping among all individuals suspected to have onychomycosis and referred to a medical mycology laboratory between June 2019 and March 2022. Species of yeast isolates were identified using the multiplex PCR and PCR-RFLP methods. The antifungal susceptibility of isolates to common antifungal agents and imidazole drugs was evaluated according to the M-27-A3 CLSI protocol. Among 101 yeast strains isolated from onychomycosis, Candida parapsilosis complex (50.49%) was the most common species, followed by C. albicans (20.79%) and C. tropicalis (10.89%). Rare species of yeasts such as C. guilliermondii and Saccharomyces cerevisiae were also identified by molecular methods. Results obtained from antifungal susceptibility testing showed significant differences in MIC values of isoconazole, fenticonazole, and sertaconazole among different species. Overall, a fluconazole-resistant rate of 3% was found among Candida species. Moreover, there was a statistically significant difference in MICs of fenticonazole and clotrimazole between the two most prevalent causative species, C. parapsilosis complex and C. albicans. Correct identification of the causative agents of onychomycosis and performing susceptibility testing could be helpful in choosing the most appropriate antifungal therapy.

Cutaneous Candidiasis at the Avicenne Military Hospital in Marrakech: A Five-Year Assessment

Background: Candidiasis is a disease caused by yeasts of the genus Candida. They can be mucocutaneous or deep. The objective of this work is to describe the epidemiology of cutaneous candidiasis. Patients and Method: This retrospective study covers five years (01/2017 to 12/2021). It includes all superficial and deep samples sent to or taken from the mycology-parasitology laboratory of the Avicenne military hospital in Marrakech. Results: In our series, Candida onychomycosis was most common in women. The age group most affected by Candida onychomycosis was between 45 and 60. The majority of patients were outpatients. Onychomycoses were mainly found on the fingers. For epidermomycosis, the sex ratio was 1. No cases were affected by epidermomycosis in the 16 to 30 age group. Most patients with epidermomycosis were outpatients. Involvement of hairless skin accounted for 41.66% of all epidermomycosis diagnosed. For Candida otitis externa, the average age was 44.18 years. The sex ratio M/F was 0.75. Eleven patients were outpatients. The most frequently isolated species was Candida albicans. Conclusion: Candidiasis is an opportunistic infection favored by several factors. The Candida albicans species remains the most common cause of candidiasis, although non-albicans species are increasingly present with the emergence of new strains.

Molecular Identification of Candida Species Isolated from Onychomycosis with In Vitro Antifungal Susceptibility Profiles

Background: Onychomycosis is one of the most common fungal infections. The most common etiological agents of onychomycosis in Iran are Candida species, especially fingernails. It is more common in women than men, particularly workers in occupations requiring them to submerge their hands or feet in water for prolonged periods. Objectives: The current study's main aim was to determine the abundance of candidal onychomycosis, identify the Candida species using molecular methods, and evaluate the in vitro antifungal susceptibility profiles. Methods: One hundred forty samples were obtained from patients suspected of onychomycosis, and 51 (36.4%) Candida strains were identified by PCR-RFLP. The in vitro susceptibility of four triazole (FLC, ITC, VRC, and POS) antifungal drug testing of 51 Candida species was performed using broth microdilution. Results: Direct microscopic examination by KOH 20% of 140 nail samples showed that 51 (36.4%) samples were positive in terms of fungal elements, with Candida parapsilosis complex being the most frequently isolated of patients, followed by C. albicans complex, C. glabrata, C. krusei, C. tropicalis, C. guilliermondii, C. famata, C. kefyr, and Candida species. All Candida species showed they were susceptible to four triazoles, except that five C. krusei were resistant to fluconazole. Only one C. glabrata isolates and one C. parapsilosis isolate were resistant to fluconazole. Conclusions: The growing trend towards the frequency of fingernail onychomycosis in housewives has been noticeable in the last decades in Iran. Therefore, accurate identification of Candida species and perform in vitro antifungal susceptibility testing can aid physicians in choosing an effective potential drug for treating onychomycosis patients.

Dermatophyte antigen kit: A useful diagnostic tool for onychomycosis.

A dermatophyte antigen kit (DQT) was released in Japan as an in vitro diagnostic tool to identify tinea unguium in June 2022. From July 2022 to February 2023, we examined 75 potassium hydroxide (KOH)-negative patients (male, n = 23; female, n = 52; mean ± SD age, 63.6 ± 13.9 years) and determined the accuracy in confirming the fungal element with ZoomBlue™ staining at 400× magnification. The DQT results were classified into three categories. DQT-positive onychomycosis was detected in 27 patients with tinea unguium and two with non-dermatophyte onychomycosis. Fungal cultures were positive in 14 (51.8%) patients (Trichophyton rubrum [n = 11], T. interdigitale [n = 1], Fusarium solani [n = 1], and Talaromyces muroii [n = 1]). DQT-negative onychomycosis included ten patients with cured tinea unguium and 3 with Candida onychomycosis. Twenty-three patients had DQT-negative mimics for onychomycosis (onychauxis [n = 11], traumatic onycholysis [n = 8], yellow nail syndrome [n = 5], pincer nail deformity [n = 3], brittle nail syndrome [n = 2], contact dermatitis [n = 2], lichen planus [n = 1] and psoriasis [n = 1]). Because sparse, atrophic and/or fragmented mycelia are invisible in direct microscopy with potassium hydroxide (KOH) at 100× magnification, DQT was beneficial for diagnosing onychomycosis.

Low positivity rate and high percentage of nondermatophyte molds in an analysis of 35,257 fungal nail culture results from a United States national commercial laboratory, 2019-2022

Low positivity rate and high percentage of nondermatophyte molds in an analysis of 35,257 fungal nail culture results from a United States national commercial laboratory, 2019-2022

Itraconazole in the treatment of superficial cutaneous and mucosal Candida infections.

Superficial cutaneous and mucosal Candida infections are common and widely affect both the immunocompromised as well as the immunocompetent populations. Common infections may include Candida paronychia, cutaneous candidiasis, oral candidiasis, vulvovaginal candidiasis, and Candida onychomycosis. Although C albicans has been considered to be the most common pathogen, other Candida species have emerged as potential causes of certain infections. Currently, a variety of antifungal agents is available to treat these infections. They include fluconazole, ketoconazole, and itraconazole. These agents have been widely used to treat fungal infections, including superficial and systemic candidiasis. However, some concerns exist regarding safety associated with longterm use of ketoconazole, and emerging issues of Candida resistance to fluconazole in some patient subsets have been reported. Itraconazole has proven efficacy in treating cutaneous and mucosal Candida infections. Additionally, studies have demonstrated that itraconazole may have increased efficacy and an excellent safety profile when administered in a pulse-dose, or intermittent fashion, for superficial mycotic infections. Itraconazole is an effective agent that warrants consideration when selecting treatment for Candida infections.

Etiology, Clinical Spectrum, Epidemiology, New Developments in Diagnosis and Therapeutic Management of Onychomycosis: An Update

Fungal infections are recognized as an important cause of morbidity as well as mortality, especially in the immune-suppressed subjects worldwide. Onychomycosis is a sporadic fungal infection that can affect any part of the nail unit, including the matrix, bed, and plate. It is caused by a wide variety of fungi that include dermatophytes, yeasts, and non-dermatophyte moulds. Dermatophytes are the most common cause of onychomycosis among the numerous fungi. The disease is mainly sporadic and has been recorded in sexes, all age groups, in rural and urban settings, and developing and developed countries. Onychomycosis affects more than 5% of the world's population today. Distal lateral subungual onychomycosis (DLSO), white superficial onychomycosis (WSO), proximal subungual onychomycosis (PSO), endonyx onychomycosis (EO), and candidal onychomycosis are the five primary subtypes of onychomycosis. The condition can manifest itself in a variety of clinical forms, all of which impact the nails on the fingers and legs. Generalized infections involving both hands have been found on occasion. The infection in immunocompromised patient may cause a serious health problem. A plethora of factors, such as nail trauma, occlusive foot wear, and humidity may predispose to fungal nail infections. Clinical diagnosis should be supported with laboratory findings. Direct microscopic demonstration of the fungal agent in the afflicted nail using the potassium hydroxide procedure and isolation of fungi in pure culture on mycological media, such as Sabouraud dextrose agar, dermatophyte test medium, and Pal sunflower seed agar helps to confirm the diagnosis of onychomycosis. The precise morphology of fungal cultures taken from the clinical specimens of patients can be easily investigated in staining solutions, such a PHOL and Narayan. Direct microscopy in potassium hydroxide is still considered the simplest, quickest, and cheapest way to detect fungal agents in nail scrapings. Onychomycosis medications can be applied locally (amorolfine, ciclopirox, efinaconazole, tavaborole) or taken orally (fluconazole, itraconazole, terbinafine). The cure rate is increased when topical and systemic treatments are used together. Depending on the extent of nail involvement, therapy might last from 3 to 6 months or even longer. It is imperative to manage the risk factors. Hygiene is considered the best prevention strategy of onychomycosis.

Primary Cutaneous Mucormycosis, Candida Onychomycosis and Endophthalmitis in a Patient with CARD9 Mutation.

Primary Cutaneous Mucormycosis, Candida Onychomycosis and Endophthalmitis in a Patient with CARD9 Mutation.

MOLECULAR DETECTION OF THE TWO VIRULENCE GENES HWP1 AND ALS1 IN CANDIDA SPECIES ISOLATED FROM ONYCHOMYCOSIS

The aim: This article was aimed to assess the prevalence of Candida species causing nail infections and to investigate the most important virulence genes that cause adhesion. Materials and methods: Samples were collected from General Hospital and the outpatient's clinics in Thi-Qar Province, southern Iraq, during the period from January 2021 to May 2021. Samples were inoculated on Sabouraud Dextrose Agar plates containing 0.5 mg chloramphenicol, then Petri dishes were incubated at 30°C under aerobic conditions and observed for Candida species growth for 24-72 hrs. All isolates were identified by morphologic and chromatic properties on CHROMagar and by Api Candida. Results: Twenty five isolates were obtained from hundred samples, which belong to five species of the genus Candida, distributed in percentage 9(36%), 4(16%), 4(16%), 4(16%) and 3(12%) of C. glabrata, C. krusei, C. albicans, C. famata and C. tropicalis consecutively and one isolate was not identified. Monoplex PCR technique was used to detect virulence genes (hwp1 and als1) of Candida species. Four Candida albicans isolates (16%) were carried of both hwp1 and als1 genes. Conclusions: The virulence gene (hwp1) can be relied upon in molecular detection as a special diagnostic tool of Candida albicans species except other types causing Candidal onychomycosis.

Candidal Onychomycosis: Clinicoepidemiological Profile, Prevailing Strains, and Antifungal Susceptibility Pattern-A Study from a Tertiary Care Hospital.

Background:Despite an increasing trend of onychomycosis caused by Candida species in recent years, there is a scarcity of published data.Objective:To determine the epidemiological and clinical characteristics of Candida onychomycosis, to identify the prevalent, and perform in-vitro antifungal susceptibility testing (AFST) of the isolates.Methodology:A total of 506 consecutive patients with a clinical suspicion of onychomycosis were included in a cross-sectional clinical study. Nail scrapings and clippings were subjected to KOH examination and culture. Species identification and antifungal drug sensitivity testing were done for Candida isolates using Vitek 2YST Compact system using Vitek 2 cards.Results:Out of 384 (75.88%) culture-positive cases, dermatophytes were isolated in 58.08%, yeast in 26.30%, and NDM in 12.24%. Of the yeast, Candida albicans was isolated in 59.4% and non-albicans species in 40.59%. AFST showed that most of Candida species exhibited 100% susceptibility to most of the antifungal drugs tested, while intermediate resistance to fluconazole and flucytosine was seen in some non-albicans species (C. krusei, C. glabrata, and C. guilliermondii). Time taken for species identification was 14–18 h (average 15.5 h), while determination of minimum inhibitory concentration took 9–27 h (average 13 h).Conclusions:Our study showcases the present scenario of Candida distribution and the resistance patterns of various species afflicting the nail unit. Furthermore, our findings clearly indicate that the carriage of this pathogenic yeast is seen in both healthy individuals as well as with immunosuppression.

Clinical significance of Candida isolation from dystrophic fingernails.

Candida onychomycosis mostly involves fingernails. Yet, in contrast to dermatophytes, Candida isolation from dystrophic fingernails does not prove casualty, as sample contamination and non-pathogenic Candida growth occur. Characterising treatment outcome of Candida-positive dystrophic nails is crucial to avoid unnecessary treatment. To investigate predicators associated with treatment outcome among Candida-positive dystrophic fingernails. A retrospective cohort study was carried out among 108 adults with Candida-positive dystrophic fingernails not cured with adequate systemic anti-fungal course. Diagnosis was based on a single mycological culture. Patients with treatment failure (n=85; 78.7% of the cases) were compared to patients with partial response (mild to almost cure; n=23; 21.3% of the cases) at 9 to 12months following treatment initiation. Treatment failure was significantly associated with primary onycholysis (odds ratio [OR] 2.8; 95% confidence interval [CI] 1.1-7.4) and prolonged dystrophy (12.8 vs. 3.7years in average), compared to partial treatment response. Non-responders had lower odds to present with distal lateral subungual onychomycosis, compared to partial responders (OR 0.3; 95% CI 0.1-0.7). Demographic and mycological characteristics, as well as number of nails affected, co-presence of paronychia, and treatment regime were not found to be associated with treatment response. Candida-positive primary onycholysis was shown to be non-responsive to systemic anti-fungal treatment, suggesting that anti-fungal treatment is not indicated. For other clinical scenarios, high proportions of treatment non-response suggest that determining causality of Candida should not be based on a single positive mycological culture.

Candida Onychomycosis: an Old Problem in Modern Times

This review summarizes the main findings in the Candida onychomycosis (CO) literature as well as provides data for clinical practice. Due to the increase in the frequency of immunosuppression-generating diseases, CO has been observed to be an entry route for systemic infections that worsen the prognosis of these patients. Onychomycosis are common fungal nail infections, and the main cause is related to dermatophytes. The second cause of onychomycosis is related to Candida, frequently associated with both local and systemic immune disturbances. Candida onychomycosis (CO) is observed in the elderly or among patients with diseases related to immunosuppression such as diabetes mellitus or HIV or while using immunosuppressive therapy and extended-spectrum antibiotics. Among the local factors related to CO are nail trauma, poor hygiene, excessive cutaneous moisture, and occupational exposure to chemicals (detergent, soaps). The diagnosis of CO requires an adequate history, a detailed physical examination, and a positive direct microscopy and culture; also, histopathology is often needed. Initial measures to treat the disease include the control of the associated diseases as well as the risk factors, improvement of the immune system, and the eradication of the fungus. Despite its worldwide frequency, there is little information in the literature regarding the epidemiology, pathogenesis, and antifungal susceptibility of CO.

In vitro antifungal susceptibility testing of fungi in patients with onychomycosis.

Onychomycosis is the most common nail disorder. To examine in vitro antifungal susceptibility of fungi among onychomycosis patients. The study included 68 patients with onychomycosis. Nail specimens were cultured on Sabouraud dextrose agar and Dermasel agar base-media. Isolated fungi were subjected to antifungal susceptibility tests against terbinafine, itraconazole, fluconazole, and griseofulvin. Candida species (Candida spp.) were detected in 32.4% of the cases of candidal onychomycosis (n = 37), 23.5% of the cases of distal and lateral subungual onychomycosis (n = 17), and 21.4% of the cases of total dystrophic onychomycosis (n = 14). Candida spp. were sensitive to fluconazole in 73.5%, itraconazole in 58.8%, and terbinafine in 5.9% of the cases. Aspergillus spp. were sensitive to itraconazole in all cases, and terbinafine in 87.5% of cases. Penicillium spp. were sensitive to itraconazole and terbinafine in 88.9% and 77.8% of cases, respectively. Trichophyton spp. were sensitive to terbinafine and resistant to itraconazole. Microsporum spp. were sensitive to itraconazole and resistance to terbinafine. All isolated fungi were resistant to griseofulvin. An increasing proportion of Candida spp. was observed among patients with different clinical varieties of onychomycosis. Candida spp. were highly sensitive to fluconazole and a lesser extent to itraconazole.

Conventional Photodynamic Therapy versus Fractional CO2 Laser Assisted Photodynamic Therapy in Treatment of Onychomycosis

Abstract Background Onychomycosis is a common persistent infection of the nail unit by fungi either dermatophytes, yeasts or non-dermatophyte molds (NDMs). It is classified clinically to distal and lateral subungual onychomycosis (DLSO), superficial white onychomycosis (SWO), proximal subungual onychomycosis (PSO), candidal onychomycosis, endonyx onychomycosis and total dystrophic onychomycosis (TDO). Onychomycosis is commonly confirmed by clinical examination side by side with regular diagnostic techniques such as direct microscopy and fungal culture, which are considered the golden are considered the golden standards of diagnosis. Aim of the Work to evaluate two PDT approaches in the treatment of onychomycosis. The study will compare the effect of PDT using conventional method versus fractional CO2 assisted PDT for achievement of a clinical and mycological cure in cases of onychomycosis. Patients and Methods we conducted a right-left controlled study, on 21 patients with at least 2 toenails onychomycosis in the same patient. These patients were recruited from outpatient clinic of dermatology department at Ain Shams University Hospitals. The study was conducted during the period from December 2016 till June 2017. Twenty-one patients (4 males and 17 females) with clinical signs of toenail onychomycosis were enrolled in the study. The diagnosis was confirmed via laboratory studies. Results in our study, we found that Aspergillus species were the most common causative organisms of OM followed by and this is possibly because the non NDMs are more frequent in tropical and subtropical areas with a hot and humid climate. Conventional PDT and fractional CO2-assisted PDT have an antifungal activity as manifest by a mycological cure rate of 57.1% and 76.2% in OM cases respectively. Fractional CO2-assisted PDT was superior to conventional PDT as regard the clinical improvement in nail appearance and patient satisfaction. Conclusion non-dermatophyte molds are important and common pathogens in toenail onychomycosis. Aspergillus species play an important role as pathogens for toenail onychomycosis in Egypt.

Translation elongation factor 1-alpha gene as a marker for diagnosing of candidal onychomycosis.

Background and Purpose:Culture-based identification methods have been the gold standard for the diagnosis of candidal onychomycosis. Molecular technologies, such as polymerase chain reaction (PCR) assays, can provide an alternative for the rapid detection of Candida species. The present study was conducted to investigate a pan-Candida PCR assay based on the translation elongation factor 1-alpha (TEF-1α) gene for the detection of the most prevalent pathogenic Candida species.Materials and Methods:For the purpose of the study, an optimized pan-Candida PCR primer pair was designed, and the target was amplified and sequenced. The analytical and clinical diagnostic performance of the designed primers was tested using 17 reference strains, 137 nail scrapings suspected of onychomycosis, and 10 healthy nail specimens.Results:The use of the universal pan-Candida primers designed on TEF-1α gene resulted in the successful amplification of a 270-base pair fragment in all Candida species tested, except for C. glabrata, and reacted neither with other fungi nor with E. coli. The sequence difference count matrix showed poor insertion/deletion differences (0-2 nt) among Candida species. Among 137 nail specimens, 35% (n=48), 30.7% (n=42), and 40.1% (n=55) of the samples were found to be positive by direct microscopy, culture, and pan-Candida PCR, respectively.Conclusion:Based on the findings, the PCR-based detection targeting the DNA TEF-1α gene is a rapid and simple procedure for the diagnosis of candidal onychomycosis directly from nail sample.

Distal and lateral subungual onychomycosis of the finger nail in a neonate: a rare case

BackgroundOnychomycosis is extremely rare in neonates, infrequently reported in children and is considered to be exclusively a disease of adults.Case presentationWe, herein report a case of fingernail onychomycosis in a 28-day-old, healthy, male neonate. The child presented with a history of yellowish discoloration of the fingernail of the left hand for one week. The etiological agent was demonstrated both by microscopic examination and culture of nail clippings. The isolate grown on culture was identified as Candida albicans by phenotypic characteristics and by matrix-assisted laser desorption ionization-time of flight mass spectrometry. Antifungal sensitivity testing was performed by broth dilution method as per the Clinical & Laboratory Standards Institute guidelines. An oral swab culture of the child also yielded C. albicans with the same antibiogram as the nail isolate. The case was diagnosed as distal and lateral subungual candida onychomycosis of severity index score 22 (severe) and was treated with syrup fluconazole 6 mg/kg body weight/week and 5% amorolfine nail lacquer once/week for three months. After three months of therapy, the patient completely recovered with the development of a healthy nail plate.ConclusionsThe case is presented due to its rarity in neonates which, we suppose is the first case report of onychomycosis from Nepal in a 28-day-old neonate. Oral colonization with pathogenic yeasts and finger suckling could be risk factors for neonatal onychomycosis.

Species distribution and epidemiological characteristics of superficial fungal infections in Southeastern Serbia.

Superficial fungal infections (SFI), one of the most prevalent diseases in the world, are infections of keratin-rich structures of human body mostly caused by dermatophytes and yeasts. The goal of this study was to determine the possible changes in the epidemiology of SFI on the territory of Southeastern Serbia and to investigate epidemiological characteristics and the influence of SFI on the patient's quality of life. From 2012 to the end of 2017, samples of 1643 patients (568 males and 1075 females, mean age 40.32±22.44years) with suspected SFI from Southeastern Serbia were examined using the standard mycological methods. The questionnaires were used to investigate epidemiological characteristics. Superficial fungal infections were diagnosed in 20.5% (n=336) of patients. In the group of dermatophytes, the most prevalent was Microsporum canis (63.9%, n=76) followed by Trichophyton mentagrophytes (21.8%, n=26). Non-albicans Candida species were dominant aetiological agents of superficial candidosis (62.3%). BMI ≥25kg/m2 (P=0.019) was determined as an independent risk factor for SFI. There was a statistically significant difference in the EQVAS score between the groups of patients and the control group (P<0.001). Results of conducted study indicate that SFI prevalence has not changed in the previous period. However, increase of Candida-SFI prevalence, especially Candida onychomycosis, was established.

ДЕСТРУКТИВНИЙ УСКЛАДНЕНИЙ ПОЛІОНІХОМІКОЗ І ВРОСТАННЯ НІГТІВ: КЛІНІКО-БІОХІМІЧНІ ПАРАЛЕЛІ (КЛІНІЧНІ СПОСТЕРЕЖЕННЯ)

ДЕСТРУКТИВНИЙ УСКЛАДНЕНИЙ ПОЛІОНІХОМІКОЗ І ВРОСТАННЯ НІГТІВ: КЛІНІКО-БІОХІМІЧНІ ПАРАЛЕЛІ (КЛІНІЧНІ СПОСТЕРЕЖЕННЯ)