Advances in Onychomycosis Research

A special issue of Journal of Fungi (ISSN 2309-608X). This special issue belongs to the section "Fungal Pathogenesis and Disease Control".

Deadline for manuscript submissions: closed (1 May 2025) | Viewed by 1498

Special Issue Editor


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Guest Editor
Dermatology, Sheba Medical Cenet-Tel Hashomer, Tel Aviv University, Tel Aviv-Yafo, Israel
Interests: dermato-mycology; nail disorders; onychomycosis diagnosis and treatment

Special Issue Information

Dear Colleagues,

The Special Issue, entitled ‘Onychomycosis’, aims to present the precise definition of onychomycosis and address its management with or without the preferred treatment:

  1. Diagnostic Improvements: Recent research highlights significant advancements in diagnostic techniques for onychomycosis such as polymerase chain reaction (PCR), especially in cases where traditional methods, such as direct microscopy and culture, are negative while the clinical presentation supports onychomycosis.
  2. The gold-standard treatment for onychomycosis is systemic treatment. Emerging treatments such as topical therapies (new topical treatments) are being developed to improve drug penetration and efficacy, laser therapy and photodynamic therapy (PDT).
  3. The definition of treatment success: There must be uniformity in clinical studies regarding the definition of therapeutic success in onychomycosis. Since there is usually more than one affected nail in most cases, a single nail showing complete restoration is sufficient evidence of therapeutic success.
  4. Antifungal Resistance: The issue of antifungal resistance is becoming more prominent. There are various mechanisms by which fungi develop resistance to commonly used antifungals, and novel antifungal compounds with novel mechanisms of action to overcome resistance.
  5. Prevention and Recurrence: Relapse, reinfection and the host immune response.

To summarize: this Special Issue primarily addresses the correct laboratory diagnosis alongside a clinical picture consistent with onychomycosis, the consideration of pure or combined disorders, the adaptation of appropriate treatment even in cases of resistance, the interpretation of therapeutic success, and ultimately the prevention of recurrence or reinfection.

Prof. Dr. Avner Shemer
Guest Editor

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Keywords

  • Onychomycosis
  • laboratory diagnosis
  • Dermatophytes
  • yeasts
  • molds
  • Terbinafine
  • Fluconazole
  • Itraconazole
  • next-generation azoles
  • definition of treatment success
  • reinfection
  • relapse
 

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Published Papers (2 papers)

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Research

12 pages, 1210 KiB  
Article
Specific Primers and Nested PCR Find Trichophyton rubrum Missed by Culture of Ground Toenails from Onychomycosis in Podiatric Patients in Eastern Australia
by Anjana C. Santosh, Danilla Grando and Ann C. Lawrie
J. Fungi 2025, 11(7), 520; https://doi.org/10.3390/jof11070520 - 14 Jul 2025
Viewed by 365
Abstract
Toenail onychomycosis causes significant problems in public health and is more common among the elderly and immune-compromised populations. A previous culture-based survey of communal finely ground toenails from the east coast of Australia isolated 125 T. interdigitale but only one T. rubrum. [...] Read more.
Toenail onychomycosis causes significant problems in public health and is more common among the elderly and immune-compromised populations. A previous culture-based survey of communal finely ground toenails from the east coast of Australia isolated 125 T. interdigitale but only one T. rubrum. This paucity of T. rubrum was surprising because it is one of the most common dermatophytes isolated worldwide. Our aim was to find out if T. rubrum was present but not cultured. DNA was extracted from ground toenails from the same samples. New specific primers were designed for the ITS region of T. rubrum that excluded T. interdigitale and vice versa. PCR with these new primers found T. rubrum as well as T. interdigitale in all ground toenail samples. This suggests that T. rubrum was present and common in the ground toenails. It was possibly missed by culture because it grows slowly and was overgrown by T. interdigitale and non-dermatophyte moulds. Alternatively, its viability may have declined earlier, during collection, treatment, or storage of the ground toenails. This has implications for studies of clinical materials, especially nails, as infection by T. rubrum (the most common dermatophyte) may be missed by culture, the main method used in pathology laboratories. Full article
(This article belongs to the Special Issue Advances in Onychomycosis Research)
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11 pages, 998 KiB  
Article
Epidemiology and Trends of Cutaneous Fungal Infections (2019–2022) in Israel: A Single Tertiary-Center Study
by Eran Galili, Auriella Taieb, Avner Shemer, Gil Leor, Anna Lyakhovitsky, Aviv Barzilai and Sharon Baum
J. Fungi 2025, 11(4), 320; https://doi.org/10.3390/jof11040320 - 18 Apr 2025
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Abstract
Cutaneous fungal infections predominantly caused by dermatophytes are a global concern. These infections vary widely by region, age, and body site, with recent shifts in the pathogen distribution. This study examines the distribution and trends of superficial fungal infections in a large tertiary [...] Read more.
Cutaneous fungal infections predominantly caused by dermatophytes are a global concern. These infections vary widely by region, age, and body site, with recent shifts in the pathogen distribution. This study examines the distribution and trends of superficial fungal infections in a large tertiary care center in Israel from 2019 to 2022. A retrospective analysis of 2244 patients with suspected fungal infections was performed, utilizing PCR and fungal cultures for diagnosis. Confirmed fungal infections were present in 53.0% of cases. In adults, infections predominantly affected the nails and feet, while in children, the scalp and nails were the most involved sites. Trichophyton rubrum was the most common pathogen overall, but T. tonsurans was the leading cause of scalp, face, and neck infections, as well as tinea corporis in children. T. tonsurans incidence significantly increased in adults and became the most frequent agent of upper-body tinea corporis by 2022. These findings highlight a shift in pathogen distribution, with T. tonsurans emerging as the leading cause of upper-body skin infections, underscoring the need for targeted prevention strategies and further investigation of its transmission routes. Full article
(This article belongs to the Special Issue Advances in Onychomycosis Research)
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