CAUSATIVE PATHOGENS IN ONYCHOMYCOSIS AND THE POSSIBILITY OF TREATMENTRESISTANCE - A REVIEW

Onychomycosis is caused primarily by dermatophytes, Candida species, a nd nondermatophytic molds. Dermatophytes, particularly Trichophyton ru brum, are by far the most common pathogens. There is some question as to whether Candida actually breaks down nail material or only invades the proximal nail bed. Similarly, the clinical significance of molds i s unknown, because they may be colonizing organisms rather than destru ctive pathogens. It is, therefore, important to identify the pathogen in the array of organisms that may be isolated in culture. The increas ing use of fluconazole in prophylaxis and treatment of systemic yeast infections and infections in patients with AIDS has been associated wi th the emergence of resistant Candida albicans, as well as previously minority species of Candida, such as C. glabrata and C. krusei. This m ay be of relevance to the treatment of onychomycosis with azole antifu ngals.