A Clinical and Mycological Study of Onychomycosis in the Elderly Over 10 Years (2001-2010)
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Background: As the life expectancy has risen globally because of the advance of medicine,onychomycosis in the elderly has been increasing with higher concerns over nails. Onychomycosis hasbeen studied quite extensively, however, few reports on onychomycosis in a geriatric Korean populationhave been available. Objective: The purpose of this study was to investigate the clinical features of onychomycosis in theelderly compared with other age groups and to identify the etiological agents during 10-year period. Methods: A total of 629 patients over 65 years of age had been diagnosed with onychomycosisduring a 10-year period (2001-2010). The etiological agents were identified by cultures on Sabouraud'sdextrose agar with and without cycloheximide. Nondermatophytic molds and yeasts were considered aspathogens, if the identical fungal elements were observed at the initial direct microscopy and repeatedlyin specimen-yielding cultures at a follow-up visit. Results: The 629 elderly patients represented 22.1% of all onychomycosis patients. Toenails wereinvolved in 567 (90.1%) patients; fingernails in 39 (6.2%); both toenails and fingernails in 23 (3.7%). The ratio of male to female was 1.01:1. Associated systemic diseases were found in 327 (52.0%)cases. Distal and lateral subungual onychomycosis (80.2%) was the most common clinical type ofonychomycosis, followed by TDO (10.7%), SWO (6.2%) and PSO (2.9%). TDO was increasingsignificantly in the elderly. Organisms causing onychomycosis were dermatophytes (76.5%), yeasts(14.3%) and nondermatophytic molds (9.2%). The most common cause of onychomycosis in the elderlywas Trichophyton rubrum. Nondermatophytic molds were more frequently responsible for onychomycosisin the elderly. Conclusion: Onychomycosis has been increased in the elderly and there are many differences fromother age groups in aspects of clinical features, associated diseases and etiologic agents. Therefore, wesuggest the need of a careful mycological examination in the elderly patients with onychomycosis.
Abstract
Background: As the life expectancy has risen globally because of the advance of medicine,onychomycosis in the elderly has been increasing with higher concerns over nails. Onychomycosis hasbeen studied quite extensively, however, few reports on onychomycosis in a geriatric Korean populationhave been available. Objective: The purpose of this study was to investigate the clinical features of onychomycosis in theelderly compared with other age groups and to identify the etiological agents during 10-year period. Methods: A total of 629 patients over 65 years of age had been diagnosed with onychomycosisduring a 10-year period (2001-2010). The etiological agents were identified by cultures on Sabouraud'sdextrose agar with and without cycloheximide. Nondermatophytic molds and yeasts were considered aspathogens, if the identical fungal elements were observed at the initial direct microscopy and repeatedlyin specimen-yielding cultures at a follow-up visit. Results: The 629 elderly patients represented 22.1% of all onychomycosis patients. Toenails wereinvolved in 567 (90.1%) patients; fingernails in 39 (6.2%); both toenails and fingernails in 23 (3.7%). The ratio of male to female was 1.01:1. Associated systemic diseases were found in 327 (52.0%)cases. Distal and lateral subungual onychomycosis (80.2%) was the most common clinical type ofonychomycosis, followed by TDO (10.7%), SWO (6.2%) and PSO (2.9%). TDO was increasingsignificantly in the elderly. Organisms causing onychomycosis were dermatophytes (76.5%), yeasts(14.3%) and nondermatophytic molds (9.2%). The most common cause of onychomycosis in the elderlywas Trichophyton rubrum. Nondermatophytic molds were more frequently responsible for onychomycosisin the elderly. Conclusion: Onychomycosis has been increased in the elderly and there are many differences fromother age groups in aspects of clinical features, associated diseases and etiologic agents. Therefore, wesuggest the need of a careful mycological examination in the elderly patients with onychomycosis.
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