Pediatric Onychomycosis: 10-Year Evaluation in a Tertiary Hospital in Brazil - Abstract
Introduction: Onychomycosis is a rare nail fungal infection in children and few authors have evaluated the topic in Brazil. This study aimed to evaluate the clinical characteristics and pathogens of onychomycosis in the pediatric population in a tertiary hospital in Brazil. Methods: Retrospective and analytical study with review of medical records from a tertiary hospital in southern Brazil, evaluating patients up to 18 years of age and suspected diagnosis of onychomycosis. Data were tabulated and analyzed using JMP 10 software. Results: Evaluated 77 medical records of patients with suspected onychomycosis, in 47 (61%) the infection was confirmed, 26 by histopathology by nail clipping and 21 by positive culture by nail scraping, the latter comprising the final sample. Thirteen cases (61.9%) were male and the median age was 11.3 years. The most frequent pathogen was Trichophyton rubrum (33.3%). Eight patients (66.7%) were treated with topical antifungal agents only, and all were cured, with a median time of 12 months. Discussion: Although infrequent in the pediatric age group, an increase in the overall prevalence of onychomycosis is observed in this population. Trichophyton rubrum was the main pathogen, but there is a lacking of studies and divergent results regarding the main agent responsible for onychomycosis in the Brazilian population. Topical treatment was the most used, an important particularity of pediatric patients. Systemic antifungals have a higher risk of adverse events and require adjusted doses for children and adolescents. Topical treatment may be a good alternative in this population that has thinner and faster growing nails, showing greater response to treatment than adults. Conclusion: Onychomycosis is an important differential diagnosis in nail dystrophies. Trichophyton rubrum was the main pathogen causing the disease. Topical antifungal treatment was the most used, a particularity of pediatric patients, and may present a better response compared to adults.