Abstract

Background: Clinical classification of onychomycosis is commonly divided into 4 clinical types but some authors suggest 5 clinical types. Pathogenic fungi, treatment response and prognosis of onychomycosis are different dependent upon the clinical type. Therefore, suitable clinical classification is necessary before treatment.

Objective: The primary aim of this study was to investigate the incidence and distribution of 4 clinical types of onychomycosis: distal and lateral subungual onychomycosis (DLSO), superficial white onychomycosis (SWO), proximal subungual onychomycosis (PSO), total dystrophic onychomycosis (TDO). The secondary aim of this study was to clarify the DLSO, the most common type of the onychomycosis, by dividing it into 4 subtypes.

Methods: The diagnosis of the patients were confirmed by more than 1 positive test among KOH smear, fungus culture, histopathologic test and KONCPA test. Total 817 onychomycotic nails of 589 patients (331 males, 258 females) who visited Department of dermatology, Catholic University, St. Mary hospital between January, 1999 and December, 2006 were included. Clinical photographs and charts of the patients were thoroughly reviewed and divided into 4 clinical types and 4 clinical subtypes in case of DLSO.

Results:

1. Out of 817 nails, 623 (76.3%) fell into DLSO and 82 (10.0%) TDO, 65 (7.9%) SWO, 47 (5.8%) PSO, respectively.

2. 623 nails diagnosed to be DLSO were further divided into 4 clinical subtypes: 243 (39.0%) edge types, 211 (33.9%) distal types, 104 (16.7%) linear types and 65 (10.4%) lateral types.

3. 315 males with DLSO were further divided into 4 clinical subtypes: 130 (41.3%) edge types, 96 (30.5%) distal types, 54 (17.1%) linear types and 35 (10.6%) lateral types. Females in the same group also exhibited same ranks in terms of prevalence.

4. Out of 457 big toenails, there were 193 edge types (42.2%), 141 distal types (30.9%), 77 linear types (16.8%) and 46 lateral types (10.1%). Out of 105 other toenails, there were 42 distal types (40.0%), 28 edge types (26.7%), 19 linear types (18.1%) and 16 lateral types (15.2%).

Conclusion: DLSO composed of 76.3% of onychomycosis were further classified into 4 clinical subtypes. Further clinical studies will be necessary to evaluate the value and efficacy of this subclassification in deciding the treatment methods and presumption of prognosis.

Keywords

Onychomycosis Classification Subtype

KJMM 2008 September;13(3):129-137(9). Epub 2016 February 18
Copyright © 2008 by Korean Journal of Medical Mycology

Language

Korean/English

Author

Hyo Sang Ahn; Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
Hyun Jung Park; Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
Jun Young Lee; Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
Baik Kee Cho; Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea

Corresponding

Baik Kee Cho, Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea. Tel: (02) 3779-1231, Fax: (02) 783-7604, e-mail: bkcho@catholic.ac.kr

Publication history

Acknowledgements

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Hyo Sang Ahn

Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea

Hyun Jung Park

Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea

Jun Young Lee

Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea

Baik Kee Cho

Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea

Since epub date 2016 February 18