Asian Journal of Pediatric Research

Interest of Dermoscopy for the Diagnosis of Onychopathy in an Infant

Asian Journal of Pediatric Research, Volume 11, Issue 4, Page 1-5
DOI: 10.9734/ajpr/2023/v11i4224

Abstract


Aim: Onychomycosis is a rare pathology in infants which constitutes 15.5% of onychodystrophies in children, especially those with Down syndrome and the immunocompromised. Dermosocpy is an innocuous examination allowing to guide the clinical diagnosis and to avoid invasive examinations.

Presentation of Case: 5-month-old infant presents with thickening of the thumbnail of the left hand with xanthonychia evolving for 20 days without notion of trauma. On clinical examination, xantho-pachyonychia of the thumbnail of the left hand was noted reaching the latero-distal part with subungual hyperkeratosis and peronyxis. Dermoscopy showed yellowish chromonychia, longitudinal striae, subungual hyperkeratosis with jagged edges. The mycological direct examination and culture was in favor of a Candida albicans infection The patient was put on an antifungal cream with improvement after 3 months.

Discussion: The rarity of onychomycosis in infants can be attributed to several factors such as the difference in the structure of the nail plate, less exposure to trauma and rapidity of nail regrowth. The average age is 8 months, the sex ratio at 0.98 and the preferential location is the fingernails. Clinically the nail involvement is of the disto-lateral type with subungual hyperkeratosis and peronyxis. Dermatoscopy is a quick tool showing chromonychia, longitudinal streaks, subungual hyperkeratosis producing a “ruined appearance”, distal onycholysis with jagged edges and linear hemorrhages. Infant onychomycosis is most often of candidal origin (C. albicans). Topical antifungals (ciclopirox) are preferred.

Conclusion: This case is being reported to highlight the important role of dermoscopy in the diagnosis of onychomycosis and thus prevent unnecessary biopsies.

Keywords:
  • Infant
  • onychomycosis
  • dermoscopy
  • albicans
  • peronyxis
  • pachyonychia
  • chromonychia

How to Cite

Khabba , C. A., Asermouh , M., Ismaïli , N., & Senouci , K. (2023). Interest of Dermoscopy for the Diagnosis of Onychopathy in an Infant. Asian Journal of Pediatric Research, 11(4), 1–5. https://doi.org/10.9734/ajpr/2023/v11i4224

References

Larif M, Saidi W, Fathallah A, Aounallah A, Zaouali A, Boussafara L, et al. Les onychomycoses chez les nourrissons de moins d’1 an (18 cas) Annales de Dermatologie et de Vénéréologie. 2014; 141(12 Supplement):S337-S338 Available:https://doi.org/10.1016/j.annder.2014.09.258

Neocimar Saraiva Correia, Rayssa Tuanna Schmidt Balbinot, Cibele Bonacorsi, Fabiana Cristina Donofrio. Epidemiology of dermatomycoses in children in Northern Mato Grosso 2015-2020. Mycoses. 2022; 65(5):560-566. Available:https://doi.org/10.1111/myc.13439

Nikolaos Kaparos, Sarah Norrenberg, Mahdi Al-Dhafiri, Stéphanie Christen-Zaech. Altérations unguéales de l’enfant. Revue médicale Suisse. Dermatologie. 2018;600, Available:https://doi.org/10.53738/REVMED.2018.14.600.0676

Daniela A Alfaro S, Carmen G González F. Pediatric onychomycosis: Update and management. Rev Chil Pediatr. 2020; 91(1):131-138. Epub 2019 Dec 3 Available:https://doi.org/10.32641/rchped.v91i1.1309

Children onychomycosis. A neglected dermatophytosis: A retrospective study of epidemiology and treatment. Mycoses; 2023. Available:https://doi.org/10.1111/myc.13571

Martha Patricia Solís-Arias, Maria Teresa García-Romero. Onychomycosis in children. A review. Int J Dermatol. 2017; 56(2):123-130. Available:https://doi.org/10.1111/ijd.13392

Manasa Narayan Kayarkatte, Archana Singal, Deepika Pandhi, Shukla Das, Sonal Sharma. Nail dermoscopy (onychoscopy) findings in the diagnosis of primary onychomycosis: A cross-sectional study. Indian J Dermatol Venereol Leprol. 2020;86(4):341-349. Available:https://doi.org/10.4103/ijdvl.IJDVL_100_19.

Sif Vestergaard-Jensen, Abdullah Mansouri MD, Lise Heilmann Jensen MD, Gregor BE, Jemec MD, DrMedSci, Ditte Marie L. Saunte MD, PhD.Systematic review of the prevalence of onychomycosis in children. Pediatric Dermatology. 2022; 39(6). Available:https://doi.org/10.1111/pde.15100

Aditya K Gupta, Maanasa Venkataraman, William Abramovits, Eric P Guenin. JUBLIA (Efinaconazole 10% Solution) in the treatment of pediatric onychomycosis. Skinmed. 2021;19(3):206-210. PMID: 34303391

Aditya K Gupta, Maanasa Venkataraman, Neil H Shear, Vincent Piguet. Onychomycosis in children - review on treatment and management strategies dermatolog treat. 2022;33(3):1213-1224. Available:https://doi.org/10.1080/09546634.2020.1810607

  • 29 times
    PDF Download: 31 times

Download Statistics

Downloads

Download data is not yet available.