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Non‐dermatophyte fungi in onychomycosis—Epidemiology and consequences for clinical practice
Author(s) -
Reinel Dieter
Publication year - 2021
Publication title -
mycoses
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.13
H-Index - 69
eISSN - 1439-0507
pISSN - 0933-7407
DOI - 10.1111/myc.13251
Subject(s) - dermatophyte , medicine , dermatology , antifungal , epidemiology , nail (fastener) , nail disease , antifungal drugs , trichophyton rubrum , mycosis , regimen , intensive care medicine , surgery , paronychia , materials science , metallurgy
Onychomycoses are difficult‐to‐treat fungal infections with a high recurrence rate that relates to the anatomic and pathophysiological conditions in the nail organ and the required extended duration of treatment. Clinical‐epidemiological studies demonstrated that non‐dermatophyte molds and yeasts are the primary causative agents in 20%–30% of onychomycoses. Mixed infections with dermatophytes are observed as well. Therefore, the causative agents should be determined by fungal culture and the antifungal treatment regimen should reliably cover non‐dermatophytes, if appropriate. Systemic‐topical combination therapy involving a broad‐spectrum, locally applied antifungal may increase the mycological and clinical cure rates compared to monotherapy with systemic drugs.