title: Onychomycosis in children: an experience of 59 cases.
abstract: BACKGROUND
  Although tinea unguium in children has been studied in the past, no specific etiological agents of onychomycosis in children has been reported in Korea.
  
  
  OBJECTIVE
  The purpose of this study was to investigate onychomycosis in Korean children.
  
  
  METHODS
  We reviewed fifty nine patients with onychomycosis in children (0~18 years of age) who presented during the ten-year period between 1999 and 2009. Etiological agents were identified by cultures on Sabouraud's dextrose agar with and without cycloheximide. An isolated colony of yeasts was considered as pathogens if the same fungal element was identified at initial direct microscopy and in specimen-yielding cultures at a follow-up visit.
  
  
  RESULTS
  Onychomycosis in children represented 2.3% of all onychomycosis. Of the 59 pediatric patients with onychomycosis, 66.1% had toenail onychomycosis with the rest (33.9%) having fingernail onychomycosis. The male-to-female ratio was 1.95:1. Fourteen (23.7%) children had concomitant tinea pedis infection, and tinea pedis or onychomycosis was also found in eight of the parents (13.6%). Distal and lateral subungual onychomycosis was the most common (62.7%) clinical type. In toenails, Trichophyton rubrum was the most common etiological agent (51.3%), followed by Candida albicans (10.2%), C. parapsilosis (5.1%), C. tropicalis (2.6%), and C. guilliermondii (2.6%). In fingernails, C. albicans was the most common isolated pathogen (50.0%), followed by T. rubrum (10.0%), C. parapsilosis (10.0%), and C. glabrata (5.0%).
  
  
  CONCLUSIONS
  Because of the increase in pediatric onychomycosis, we suggest the need for a careful mycological examination of children who are diagnosed with onychomycosis.
authors.affiliation: Department of Dermatology, Dongguk University College of Medicine, Gyeongju, Korea.
authors.forename: Dong Min
authors.initials: DM
authors.lastname: Kim
authors.forename: Moo Kyu
authors.initials: MK
authors.lastname: Suh
authors.forename: Gyoung Yim
authors.initials: GY
authors.lastname: Ha
keywords: Child; Onychomycosis