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NAIL CANDIDIASIS
Author(s) -
Watanabe Shin'Ichi,
Seki Yoshihito,
Shimozuma Michiro,
Takizawa Kiyohiro
Publication year - 1983
Publication title -
the journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.9
H-Index - 65
eISSN - 1346-8138
pISSN - 0385-2407
DOI - 10.1111/j.1346-8138.1983.tb01128.x
Subject(s) - paronychia , nail (fastener) , dermatology , nail disease , medicine , onycholysis , ketoconazole , chronic mucocutaneous candidiasis , candida albicans , nail plate , pathological , pathology , antifungal , biology , disease , microbiology and biotechnology , materials science , metallurgy
Onychomycosis caused by Candida is often accompanied by paronychia. Not only the morbid changes in the nailplate caused by the true parasitism by Candida but also the secondary changes in the nail due to candidial paronychia are sometimes handled as though they were candidial onychia. Onychomycosis caused by candidial infection, i.e. , nail candidiasis, is entirely different in its pathogenetic respects from the secondary ungual changes due to candidial paronychia. The reason why both are classified together as candidial onychia appears attributable to the ambiguous characterization of their clinical and pathological features. We therefore undertook a statistical analysis of 765 cases of candidiasis who visited the Dermatological Department of Tokyo University Hospital during the period from 1969 to 1980. Of these, 25 cases of nail candidiasis (primary onychia) were sorted out, followed by clinical and pathological examinations. The results showed that nail candidiasis appeared in 14.3% of the candidial paronychia and onychia cases, and no significant differences from candidial paronychia were attributable to age or sex. On the other hand, it was found that nail candidiasis was clinically characterized by subungual hyperkeratosis, while the fungal element appeared histopathologically in the lower part of the nailplate, taking an abnormal parasitic form similar to that in dermatophytes. The pathogen causing nail candidiasis was Candida albicans and was resistant to various therapies. The only effective therapy was oral administration of Ketoconazole. Nail candidiasis is often accompanied by underlying diseases like SLE which result in cellular immunodeficiency. While chronic mucocutaneous candidiasis occurs with a background of congenital cellular immunodeficiency to Candida , nail candidiasis appears to have an acquired immunodeficiency as the background. In short, nail candidiasis can be interpreted as a candidiasis which occurs when the host/parasite relations are disturbed. In this sense, it appears that nail candidiasis can be regarded as a dermadrome which reflects cellular immunodeficiency of host.