Onychomycosis secondary to onychomadesis: an underdiagnosed manifestation.
Onychomycosis is a rare nail disorder in early childhood, while onychomadesis is a periodic idiopathic, non-inflammatory disease that affects the nail matrix and is common in children especially in those who suffer from viral infections. In this study, we investigated recent cases of onychomycosis subsequent to periods of onychomadesis in children. Sixteen young children (six males, 10 females) with a mean age of 36.5 months were diagnosed with onychomadesis, and 13 of the patients had a history of viral infection prior to nail changes. Direct microscopy of nail scaling was positive in 11 cases (68.8%), and culture was positive in the same number of cases. Four Candida species were isolated: Candida glabrata was the most frequent, found in eight cases (72.7%), while C. albicans, C. parapsilosis and C. tropicalis, each were encountered in a single case. All children were treated successfully with or without topical bifonazole therapy.
Department of Dermatology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Meirong
M
Li
Department of Pediatrics, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Zhuanggui
Z
Chen
Department of Dermatology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Songchao
S
Yin
Guangdong Provincial Dermatology Hospital, Guangzhou, China.
Ruzeng
R
Xue
Department of Dermatology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Zhirui
Z
Chen
Department of Dermatology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Huaiqiu
H
Huang
Department of Dermatology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Ling
L
Wei
Department of Dermatology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Chun
C
Lu
CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands.|Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam, Amsterdam, The Netherlands.|Peking University Health Science Center, Research Center for Medical Mycology, Beijing, China.|Shanghai Institute of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China.
Gerit Sybren
GS
De Hoog
Department of Dermatology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Wei
W
Lai
Department of Dermatology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Peiying
P
Feng
D000287:Administration, Topical; D000935:Antifungal Agents / Q000627:therapeutic use; D002175:Candida / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification* / Q000648:ultrastructure; D041221:Candida glabrata / Q000187:drug effects / Q000302:isolation & purification; D041022:Candida tropicalis / Q000187:drug effects / Q000302:isolation & purification; D002648:Child; D002675:Child, Preschool; D005260:Female; D006229:Hand Dermatoses / Q000188:drug therapy / Q000382:microbiology; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use; D007223:Infant; D008297:Male; D009260:Nail Diseases / Q000150:complications* / Q000382:microbiology*; D009262:Nails / Q000382:microbiology* / Q000473:pathology / Q000648:ultrastructure; D014009:Onychomycosis / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology
D000935:Antifungal Agents; D007093:Imidazoles; C036596:bifonazole

Candida glabrata
; onychomadesis; onychomycosis; paediatrics