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2010, Number 1

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Dermatología Cosmética, Médica y Quirúrgica 2010; 8 (1)

Diagnostic tools in onychomycosis: From KOH to molecular biology

Torres GE, Landgrave I, Fernández R, Arenas R

Language: Spanish
References: 41
Page: 39-46
PDF size: 151.33 Kb.


ABSTRACT

Tineas or dermatophytoses are a group of superficial mycoses caused by dermatophytes. Onychomycosis is a fungal nail infection and represents about 50% of nail diseases. Onychomycoses are classified in 6 clinical forms: 1) subungal distal and lateral onychomycosis, 2) white subungal proximal onychomycosis, 3) white superficial onychomycosis, 4) total dystrophic onychomycosis, 5) endonyx and 6) paronychia.
Diagnosis must be confirmed by fungal indentification though several diagnostic techniques such as direct microscopic examination with potassium hidroxyde, KOH plus DMSO and chlorazole black, histomycologic stains with PAS and cultures in Sabouraud agar, mycobiotic and DTM agar.
In the last decade significant advances have been made in molecular techniques for rapid and sensitive identification of dermatophytes improving our knowledge in taxonomy and filogenetics. Nowdays molecular biology is used to identify dermatophytes as polymerase chain reaction (PCR) in real time, or a combination of PCR with restriction fragment length polymorphism (RFLP) that could be performed in biopsy or keratin samples to identify dermatophytes species. These tests don’t have a high ratio of negative results as routinary tests. New procedures have an actual relevance for testing antifungal drugs and also to detect the emergence of resistant fungi.


REFERENCES

  1. Clayton YM. “Superficial fungal infections”. En Harper J, Oranje A, Prose N (eds.). Textbook of pediatric dermatology, Londres, Blackwell Science, 2000, 447-472.

  2. Arenas R. Micología médica ilustrada, 3a ed., México, McGraw-Hill, 2008, 61-94.

  3. Bolognia J, Jorizzo J, Rapini R. Dermatología, 1a ed., Barcelona, Elsevier, 2005, 1171-1186.

  4. Arenas R. “Dermatofitosis en México”. Rev Iberoam Micol 2002; 19: 63- 67.

  5. Saúl A. Lecciones de Dermatología, 14a ed., México, Méndez, 2006, 266- 282.

  6. Elewski BE. “Onychomycosis: Pathogenesis, diagnosis, and management”. Clin Microbiol Rev 2008; 11: 415-429.

  7. Aditya K, Gupta A, Ricci MJ. “Diagnosing onychomycosis”. Dermatol Clin 2006; 24: 365-369. EDOARDO TORRES GUERRERO MÉTODOS DIAGNÓSTICO SENONICOMICOSIS Dermatología cosmética, médica y quirúrgica Volumen 8 / Número 1 n enero-marzo de 2010 DCMQ 46

  8. Savin C, Huck S, Rolland C, Benderdouche M, Faure O, Noacco G, Menotti J, Candolfi E, Pelloux H, Grillot R, Coupe S, Derouin F. “Multicenter evaluation of a commercial PCR- enzime- linked immunosorbent assay diagnostic kit (onychodiag) for diagnosis of dermatophytic onychomycosis”. J Clin Microbiol 2007; 45: 1205- 1210.

  9. Finch J, Warshaw E. “Toenail onychomycosis: Current and future treatment options”. Dermatol Therapy 2007; 20: 31-46.

  10. Balderrama CV, Mayorga JR, Barba AB, Tarango VM. “Frecuencia de onicomicosis en la quinta uña distrófica del pie”. Med Cutan Iber Lat Am 2007; 35: 280-284.

  11. Arenas R. “Las onicomicosis. Aspectos clínicos, epidemiológicos, micológicos y terapéuticos”. Gac Med Mex 1990; 126: 84-91.

  12. Villanueva-Reyes J, Arenas R. “Onicomicosis en niños. Estudio en una población mexicana”. Dermatol Pediatr Lat 2007; 4(3): 197-203.

  13. Vásquez del Mercado E, Arenas R. “Onicomicosis en niños. Estudio retrospectivo de 233 casos mexicanos”. Gac Med Mex 2008; 144: 7-10.

  14. Lilly KK, Koshnick RL, Grill JP, Khalil ZM, Nelson DB, Warshaw EW. “Cost- effectiveness of diagnostic test for toenail onychomycosis: A repeated measure, single- blinded, cross sectional evaluation of 7 diagnostic test”. J Am Acad Dermatol 2006; 55: 620-626.

  15. Robert DT, Taylor WD, Boyle J. “Guidelines for treatment of onychomycosis”. Br J Dermatol 2003; 148: 402-410.

  16. Fari EM, Tietz HJ, Presber W, Sterry W, Graser Y. “Development of an oligonucleotide probe specific for Trichophyton rubrum”. Br J Dermatol 1999; 141: 240-245.

  17. Faegermann J. Baran A. “Epidemiology, clinical presentation and diagnosis of onychomycosis”. Br J Dermatol 2003; 149(supl. 65): 1-4.

  18. Gitte KL, Merete H, Svejgaard E. “The prevalence of onychomycosis in patients with psoriasis and other skin diseases”. Acta Derm Venereol 2003; 83: 206-209.

  19. Muñoz HL, Leyva J, Arenas R. “Onicomicosis. Su frecuencia en pacientes con psoriasis”. Dermatología Rev Mex 1999; 43(2): 41-45.

  20. Andrews DM, Burns MT. “Common tinea infections in children”. Am Pham Phy 2008; 77: 1415-1420.

  21. Moreno-Coutiño G, Toussaint-Caire S, Arenas R. “Clinical, mycological and histological aspects of white onychomycosis”. Mycoses 2009; 53: 1-4.

  22. Tosti A, Piraccini BM, Lorenzi S. “Onychomycosis caused by nondermatophyte molds: Clinical features and response to treatment of 59 cases”. J Am Acad Dermatol 2000; 42: 217-224.

  23. Dahdah M, Scher R. “Nail diseases related to nail cosmetics”. Dermatol Clin 2006; 24: 233-239.

  24. Carrillo-Muñoz JA. “Medios de cultivo en micología médica y veterinaria”. Cuadernos de Microbiología 1995; 3: 2-3.

  25. Pierard GE, Quatresooz P, Arrese JE. “Spotlight on nail histomycology”. Dermatol Clin 2006; 24: 371-374.

  26. Chang A, Wharton J, Tam S, Kovich O, Kamino H. “A modified approach to the histologic diagnosis of onychomycosis”. J Am Acad Dermatol 2007; 57: 849-853.

  27. Société Française de Dermatologie. “Modalités de diagnostic et prise en charge”. Ann Dermatol Venereol 2007; 134-S: 7-16.

  28. Saez de Ocariz MM, Arenas R, Ranero Juárez GA, Farrera EF, Monroy Ramos E. “Frequency of toenail onychomycosis in patients with cutaneous manifestations of chronic venous insufficiency”. Int J Dermatol 2001; 40: 18-25.

  29. Torres E, Arenas R, Atoche C. “Infecciones causadas por el género Malassezia”. Med Cutan Iber Lat Am 2008; 36: 265-284.

  30. Ramos L, Mellado S, Ramadán S, Bulacio L, López C. “Empleo de blanco de calcoflúor para el diagnóstico de las especies de Malassezia por microscopía electrónica”. Rev Argent Microbiol 2006; 38: 4-8.

  31. Mahoney JM, Bennet J, Olsen B. “The diagnosis of onychomycosis”. Dermatol Clin 2003; 21: 463-467.

  32. Weinberg J, Koestenblatt E, Tutrone W, Tishler H, Najarian L. “Comparison of diagnostic methods in the evaluation of onychomycosis”. J Am Acad Dermatol 2003; 49: 193-197.

  33. Summerbell RC, Haughland RA, Li A, Gupta AK. “rRNA internal transcribed spacer 1 and 2 sequences of asexual antropophilic dermatophytes related to Trichophyton rubrum”. J Clin Microbiol 1999; 37: 4005-4011.

  34. Durant JF, Fonteyne PA, Richez P, Marot L, Belkhir L, Tennstedt D, Gala JL. “Real- time PCR sequencing for detection and identification of Trichophyton rubrum as cause of culture negative of chronic granulomatous dermatophytosis”. Med Mycol 2008; 16: 1-7.

  35. Gupta AK, Zaman M, Singh J. “Diagnosis of Trychophyton rubrum from onychomycotic nail samples using polymerase chain reaction and calcofluor white microscopy”. J Am Podiatr Med Assoc 2008; 98: 224-228.

  36. Scher RK, Tavakrol A, Sigurgeirsson B, Hay RJ, Joseph WS, Tosti A, Fleckman P, Ghannoum M, Armstrong DG, Markinson BC, Elewski BE. “Onychomycosis: Diagnosis and definition of cure”. J Am Acad Dermatol 2007; 56: 939-944.

  37. Shehata AS, Mukherjee PK, Aboulatta HN, el-Akhras AI, Abbadi SH, Ghannoum MA. “Single- step PCR using (GACA) 4 primer: Utility for rapid identification of dermatophyte species and strains”. J Clin Microbiol 2008; 46: 2641-2645.

  38. Gupta AK, Zaman M, Singh J. “Fast and sensitive detection of Trichophyton rubrum DNA from the nail samples of patients with onychomycosis by a double round polymerase chain reaction based assay”. Br J Dermatol 2007; 157: 698- 703.

  39. Walberg M, Mork C, Sandven P, Jorde AT, Bjoras M, Gaustad P. “18s rDNA polymerase chain reaction and sequencing in onychomycosisi diagnostics”. Acta Derm Venereol 2006; 86: 223-226.

  40. Uchida T. “Comparative study of direct polymerase chain reaction, microscopic examination and culture-based morphological methods for detection and identification of dermatophytes in nail and skin samples”. J Dermatol 2009; 36(4): 202-208.

  41. Binstock JM. “Molecular biology techniques for identifying dermatophytes and their possible diagnosing onychomycosis in human toenail: A review”. J Am Podiatr Med Assoc 2007; 97: 134-144.




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