Onicomicosis
Revisión del tema
Palabras clave:
ONICOMICOSIS
Resumen
El término onicomicosis se refiere a la enfermedad de la uña causada por hongos. En el origen de la misma se involucran tres grupos de hongos: los dermatofitos, las levaduras y los mohos no dermatofitos.
Las onicomicosis constituyen una enfermedad frecuente en la práctica médica, con impacto considerable en lo emocional, social, laboral y económico.
En este artículo se revisan las principales características clínicas y epidemiológicas de las onicomicosis, se analizan los diferentes agentes causantes y se actualizan los aspectos relevantes de esta enfermedad haciendo énfasis en el manejo diagnóstico y terapéutico, ya que estos puntos son los que ocasionan mayores dificultades en la práctica clínica.
Finalmente, se hacen consideraciones sobre la importancia del diagnóstico micológico y el rol del laboratorio y del especialista en dicho diagnóstico y con respecto al tratamiento se enumeran recomendaciones en relación al uso de los diferentes fármacos y pautas terapéuticas.
Citas
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2) Deenning DW, Evans EG, Kibbler CC, Richardson MD, Roberts MM, Rogers TR, et al. Fortnigthly Review:Fungal nail disease:a guide to good practice, report of a Working Group of the British Society for Medical Mycology. BMJ 1995; 311:1277-81.
3) Rippon JW. Dermatofitosis y dermatomicosis. In:Rippon JW, ed. Tratado de Micología Médica, ed. México:Interamericana, 1990:186-298.
4) Gentles JC, Evans EG. Infection of the feet and nails with Hendersonula toruloidea. Sabouraudia 1970; 8:72-5.
5) Campbell CK, Mulder JL. Skin and nail infection by Scytalidium hyalinum. Sabouraudia 1977; 15(2):161-6.
6) Torres-Rodríguez JM. Actualización del diagnóstico micológico de las dermatomicosis. Rev Iberoam Micol 1986; 3(1):9-17.
7) Rubio-Calvo D, Rezusta-López A, Grasa-Jordan MP. Micopatología ungueal. Estudio micológico de las micosis y tiña unguium. Rev Iberoam Micol 1988; 5:90-9.
8) Gupta AK, Lambert J. Pharmaeconomic analysis of the new antifungal agents used to treat toenail onychomycosis in the USA. Int J Dermatol 1999; 38(2):53-64.
9) Joish VN, Armstrong EP. Newer drugs and overall costs of treating onychomycosis. Rev Iberoam Micol 2002; 19:130-2.
10) Lubeck DP. Measuring health-related quality of life in onychomycosis. J Am Acad Dermatol 1998; 38(5):64-8.
11) Scher RK. Onychomycosis is more than a cosmetic problem. Br J Dermatol 1994; 130(43):15.
12) Sais G, Jucgla A, Peyri J. Prevalence of dermatophyte onychomycosis in Spain:a cross-septional study. Br J Dermatol 1995; 132:758-61.
13) Roberts DT. Prevalence of dermatophyte onychomycosis in the United Kingdom:Results of an omnibus survey. Br J Dermatol 1992; 126 (39):23-7.
14) Heikkila H, Stubb S. The prevalence of onychomycosis in Finland. Br J Dermatol 1995; 133:699-703.
15) Elewski BE, Charif MA. Prevalence of onychomycosis in patients attempting a dermatology clinic in northeastern Ohio for other conditions. Arch Dermatol 1997; 133:1772-3.
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44) Crozier WJ. Two cases of onychomycosis due to Candida zeylanoides. Aust J Dermatol 1993; 35:311-3.
45) Gargeya IB, Pruitt WR, Meyer SA, Aherarm DG. Candida haemulonii from clinical specimens in USA. J Med Vet Mycol 1991; 29:335-8.
46) Daniel CR, Elewski BE. Candida as a nail pathogen in healty patients. J MSMA 1995; 36(11):379-81.
47) Gentili L, Bouchara JP, Cimon B, Chabasse D. Candida ciferrii:clinical and microbiological features of an emerging pathogen. Mycoses 1991; 34:125-8.
48) Hoog GS de, Guarro J, Gene J, Figueras MJ. Atlas of Clinical Fungi. 2a. ed. The Netherlands-Spain:CBS/Universitat Rovira I Virgili, 2000.
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56) Escobar Ml, Carmona-Fonseca J, Santamaria L. Onicomicosis por Malassezia. Rev Iberoam Micol 1999; 16:225-9.
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2) Deenning DW, Evans EG, Kibbler CC, Richardson MD, Roberts MM, Rogers TR, et al. Fortnigthly Review:Fungal nail disease:a guide to good practice, report of a Working Group of the British Society for Medical Mycology. BMJ 1995; 311:1277-81.
3) Rippon JW. Dermatofitosis y dermatomicosis. In:Rippon JW, ed. Tratado de Micología Médica, ed. México:Interamericana, 1990:186-298.
4) Gentles JC, Evans EG. Infection of the feet and nails with Hendersonula toruloidea. Sabouraudia 1970; 8:72-5.
5) Campbell CK, Mulder JL. Skin and nail infection by Scytalidium hyalinum. Sabouraudia 1977; 15(2):161-6.
6) Torres-Rodríguez JM. Actualización del diagnóstico micológico de las dermatomicosis. Rev Iberoam Micol 1986; 3(1):9-17.
7) Rubio-Calvo D, Rezusta-López A, Grasa-Jordan MP. Micopatología ungueal. Estudio micológico de las micosis y tiña unguium. Rev Iberoam Micol 1988; 5:90-9.
8) Gupta AK, Lambert J. Pharmaeconomic analysis of the new antifungal agents used to treat toenail onychomycosis in the USA. Int J Dermatol 1999; 38(2):53-64.
9) Joish VN, Armstrong EP. Newer drugs and overall costs of treating onychomycosis. Rev Iberoam Micol 2002; 19:130-2.
10) Lubeck DP. Measuring health-related quality of life in onychomycosis. J Am Acad Dermatol 1998; 38(5):64-8.
11) Scher RK. Onychomycosis is more than a cosmetic problem. Br J Dermatol 1994; 130(43):15.
12) Sais G, Jucgla A, Peyri J. Prevalence of dermatophyte onychomycosis in Spain:a cross-septional study. Br J Dermatol 1995; 132:758-61.
13) Roberts DT. Prevalence of dermatophyte onychomycosis in the United Kingdom:Results of an omnibus survey. Br J Dermatol 1992; 126 (39):23-7.
14) Heikkila H, Stubb S. The prevalence of onychomycosis in Finland. Br J Dermatol 1995; 133:699-703.
15) Elewski BE, Charif MA. Prevalence of onychomycosis in patients attempting a dermatology clinic in northeastern Ohio for other conditions. Arch Dermatol 1997; 133:1772-3.
16) Gupta AK, Jain HC, Lynde CW, Watteel GN, Summerbell RC. Prevalence and epidemiology of unsuspected onychomycosis in patients visiting dermatologist offices in Ontario, Canada a multicenter survey of 2001 patients. Int J Dermatol 1997; 36:783-7.
17) Gupta AK, Sibbald G, Lynde CW. Onycomychosis in childrens:Prevalence and treatment strategies. J Am Acad Dermatol 1997; 36:395-402.
18) Gupta AK, Chang P, Del Rosso JQ. Onichomycosis in childrens:prevalence and management. Pediatr Dermatol 1998; 15:464-71.
19) Ploysangam T, Lucky AW. Childhood white superficial onychomycosis caused by Trichophyton rubrum:Report of seven cases and review of the literature. J Am Acad Dermatol 1997; 36:29-32.
20) Rosseew D. Achllies foot screening project:preliminary results of patients screening by dermatologists. J Eur Acad Dermatol 1999; 12:6-9.
21) Haneke E. Fungal infections of the nail. Semin Dermatol 1991; 10:41-53.
22) Williams HC. The epidemiology of onychomycosis in Britain. Br J Dermatol 1993; 129:101-9.
23) Perea S, Ramos MJ, Garau M, González A, Noriega A, Del Palacio A. Prevalence and risk factors of tinea unguium and tinea pedis in the general population in Spain. J Clin Microbiol 2000; 38(9):3226-30.
24) Bonasse J, Asconegui F, Conti-Díaz I. Estado actual de las dermatofitosis en Uruguay. Rev Arg Micol 1982; 5(2):29-31.
25) Ballesté R, Gezuele E, Veiga R. Frecuencia de dermatofitosis en Montevideo. Congreso de la Federación Latinoamericana de Parasitología, 10. Libro de resúmenes. Montevideo:FLAP, 1991:89.
26) Cabrera R, Bonasse J, Fazzio S, Viola M, Sapriza M. Micosis superficiales. Revisión. Congreso de la Federación Latinoamericana de Parasitología, 10. Libro de resúmenes. Montevideo:FLAP, 1991:94.
27) Ballesté R, Fernández N, Mousqués N, Xavier B, Arteta Z, Mernes M, et al. Dermatofitosis en población asistida en el Instituto de Higiene. Rev Med Uruguay 2000; 16:232-42.
28) Conti-Díaz I. Estudio micológico de 85 casos de onicopatías. An Fac Med Montevideo 1964; 49(5-6):535-40.
29) Gentles JC, Evans EG. Foot infections in swimming baths. BMJ 1973; 3:260-2.
30) English MP, Gibson MD. Studies in the epidemiology of tinea pedis-I. Tinea pedis in school children. BMJ 1959; i:1442-6.
31) English MP, Wethered RR, Duncan EH. Studies in the epidemiology tinea pedis-VIII. Fungal infection in a long stay hospital. BMJ 1967; iii:136-9.
32) Cribier B, Leiva-Mena M, Rey D. Nail changes in patients infected with human immunodeficiency virus. Arch Dermatol 1998; 134:1216-20.
33) Daniel CR, Norton NA, Scher RK. The spectrum of nail disease in patients infected with human immunodeficiency virus infection. J Am Acad Dermatol 1992; 27:93-7.
34) Arrese JE, Pierard Franchimond C, Pierard GE. Fatal hyphomycosis following Fusarium onychomycosis in an immunocompromised patient. Am J Dermatopathol 1996; 18:196-8.
35) Hay RJ. Fungal skyn infectionts. Arch Dis Child 1992; 67:1065-7.
36) Summerbell RC. Epidemiology and ecology of onychomycosis. Dermatology 1997; 194(1):32-6.
37) Midgley G, Moore MK, Cook JC, Phan QG. Mycology of nail disorders. J Am Acad Dermatol 1994; 31:68-74.
38) Nichols DSH, Midgley G. Onychomycosis caused by Trichophyton equinum. Clin Exp Dermatol 1989; 14:464-5.
39) Piraccini BM, Morelli R, Stinchi C, Tosti A. Proximal subungueal onychomycosis due to Microsporum canis. Br J Dermatol 1996; 134:175-7.
40) Mazon A, Salvo S, Vives R, Valcayo A, Sabalza MA. Etiologic and epidemiologic study of dermatomycoses in Navarra (Spain). Rev Iberoam Micol 1997; 14:65-8.
41) Elewski BE. Onychomycosis:pathogenesis, diagnosis and management. Clin Microbiol Rev 1998; 11(3):415-29.
42) Hazen K. New and emerging yeast pathogens. Clin Microbiol Rev 1995; 8(4):462-78.
43) Weems. Candida parasilopsis. Epidemiology, patogenicity, clinical manifestations and antimicrobial suceptibility. Clin Inf Dis 1993; 14:756-66.
44) Crozier WJ. Two cases of onychomycosis due to Candida zeylanoides. Aust J Dermatol 1993; 35:311-3.
45) Gargeya IB, Pruitt WR, Meyer SA, Aherarm DG. Candida haemulonii from clinical specimens in USA. J Med Vet Mycol 1991; 29:335-8.
46) Daniel CR, Elewski BE. Candida as a nail pathogen in healty patients. J MSMA 1995; 36(11):379-81.
47) Gentili L, Bouchara JP, Cimon B, Chabasse D. Candida ciferrii:clinical and microbiological features of an emerging pathogen. Mycoses 1991; 34:125-8.
48) Hoog GS de, Guarro J, Gene J, Figueras MJ. Atlas of Clinical Fungi. 2a. ed. The Netherlands-Spain:CBS/Universitat Rovira I Virgili, 2000.
49) D'Antonio D, Romano F, Iacone A, Violante B, Fazii P, Pontieri E, et al. Onychomycosis caused by Blastoschizomyces capitatus. J Clin Microbiol 1999; 37(9):2927-30.
50) Mackinnon JE, Artagaveytia-Allende RC. Aspectos actuales de las moniliasis. An Fac Med Montevideo 1956; 41:275-92.
51) Calegari L, Conti-Díaz I, Civila E. Onicolisis por levaduras. Estudio micológico. Congreso de la Asociación Latinoamericana de Microbiologia, 9. Libro de resúmenes. Sao Paulo:ALAM-SBM, 1983:213.
52) Ashbee RH, Evans EG. Inmunology of disease associated with Malassezia species. Clin Microbiol Rev 2002; 15(1):21-57.
53) Civila E, Conti-Díaz I, Vignale R, Calegari L. Onixis por Malassezia (Pityrosporum) ovalis. Med Cut Ibero Lat Am 1982; 10:343-6.
54) Crozier WJ, Wise kA. Onychomycosis due to Pityrosporum. Austral J Dermatol 1993; 34:109-12.
55) Silva V, Moreno GA, Zaror L, De Oliveira E, Fischman O. Isolation of Malassezia furfur from patient with onychomycosis. J Med Vet Micol 1997; 35:73-4.
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Publicado
2003-08-31
Cómo citar
1.
Ballesté R, Mousqués N, Gezuele E. Onicomicosis. Rev. Méd. Urug. [Internet]. 31 de agosto de 2003 [citado 17 de noviembre de 2024];19(2):93-106. Disponible en: http://www2.rmu.org.uy/ojsrmu311/index.php/rmu/article/view/938
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