Prevalence and epidemiology of toenail onychomycosis in diabetic subjects: a multicentre survey
1998/10/01 by Aditya K. Gupta, Gupta, Konnikov +8 · 25 citations
Medicine · Biochemistry, Genetics and Molecular Biology · #Nail Diseases and Treatments #Plant Pathogens and Fungal Diseases #Fungal Infections and Studies
paper · doi:10.1046/j.1365-2133.1998.02464.x
Abstract
The number of individuals diagnosed with diabetes mellitus is increasing. The diabetic may present with complications involving all systems of the body. While onychomycosis is often observed in diabetics, there have been no large studies on the prevalence of the condition in this patient group. We examined the prevalence of onychomycosis in diabetics attending diabetes and dermatology clinics in London, Ontario, Canada and Boston, MA, U.S.A. Diabetic subjects seen in dermatology offices were for unrelated dermatoses; those referred specifically for the management of onychomycosis were excluded from the sample. A total of 550 diabetic subjects was evaluated (283 males and 267 females), age 56.1 +/- 0.7 years (mean +/- SEM). Patients with type I diabetes constituted 34% of the sample. The racial origin was: 531 Caucasians, 17 Asians, one African-American and one American-Indian. Abnormal-appearing nails and mycological evidence of onychomycosis (mostly due to dermatophytes) were present in 253 (46%) and 144 (26%), respectively, of 550 subjects. The development of onychomycosis was significantly correlated with age (P < 0.0001) and male gender (P < 0.0001). Males were 2.99 times more likely to have onychomycosis compared with females (95% confidence interval, CI 1.94-4 61). After controlling for age and sex, the risk odds ratio for diabetic subjects to have toenail onychomycosis was 2.77 times compared with normal individuals (95% CI 2.15-3.57). After controlling for age and sex, a stepwise logistic regression demonstrated that significant predictors for onychomycosis included a family history of onychomycosis (P = 0.0001), concurrent intake of immunosuppressive therapy (P = 0.035) and peripheral vascular disease (P = 0.023). Toenail onychomycosis was present in 26% of the sample and is projected to affect approximately one-third of subjects with diabetes. Predisposing factors include increasing age, male gender, family history of onychomycosis, concurrent intake of immunosuppressive agents and peripheral vascular disease.
Cited by
- Allergy and dermatophytes. [europepmc]
- Can the use of a topical antifungal nail lacquer reduce risk for diabetic foot ulceration? Results from a randomised controlled pilot study. [europepmc]
- The prevalance, epidemiology and risk factors for onychomycosis in hemodialysis patients. [europepmc]
- Safety and efficacy of tinea pedis and onychomycosis treatment in people with diabetes: a systematic review. [europepmc]
- VT-1161 dosed once daily or once weekly exhibits potent efficacy in treatment of dermatophytosis in a guinea pig model. [europepmc]
- Laser therapy for onychomycosis in patients with diabetes at risk for foot complications: study protocol for a randomized, double-blind, controlled trial (LASER-1). [europepmc]
- In vitro antifungal activity of ME1111, a new topical agent for onychomycosis, against clinical isolates of dermatophytes. [europepmc]
- Onychomycosis in diabetic patients in Fako Division of Cameroon: prevalence, causative agents, associated factors and antifungal sensitivity patterns. [europepmc]
- Understanding the formidable nail barrier: A review of the nail microstructure, composition and diseases. [europepmc]
- Oral antifungal medication for toenail onychomycosis. [europepmc]
- Candida sp. Infections in Patients with Diabetes Mellitus. [europepmc]
- Investigation of diabetic patient's fingernail quality to monitor type 2 diabetes induced tissue damage. [europepmc]
- Recent advances in therapies for onychomycosis and its management. [europepmc]
- Internal environment of footwear is a risk factor for tinea pedis. [europepmc]
- Immunopathogenesis of Dermatophytoses and Factors Leading to Recalcitrant Infections. [europepmc]
- Prevalence of Onychomycosis in Diabetic Patients: A Case-Control Study Performed at University Hospital Policlinico in Catania. [europepmc]
- Onychomycosis: Old and New. [europepmc]
- Risk Factors and Treatment Trends for Onychomycosis: A Case-Control Study of Onychomycosis Patients in the All of Us Research Program. [europepmc]
- Prevalence and risk predictors of onychomycosis in patients on hemodialysis: an observation, prospective, and unicenter study in Brazil. [europepmc]
- Antifungal Selection for the Treatment of Onychomycosis: Patient Considerations and Outcomes. [europepmc]
- Association between onychomycosis and ulcerative complications in patients with diabetes: a longitudinal cohort study in Dutch general practice. [europepmc]
- Nails in older adults. [europepmc]
- Tinea Incognito: Challenges in Diagnosis and Management. [europepmc]
- Diabetic Foot and Fungal Infections: Etiology and Management from a Dermatologic Perspective. [europepmc]
- Prevalence and Risk Factors Predicting Onychomycosis in Patients with and Without Diabetes Mellitus in Spain: A Cross-Sectional Study. [europepmc]
Related