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- Presentation
Up-to-date Treatment of Dermatophytoma
Description
The presentation discusses dermatophytomas, a specific type of onychomycosis first described in 1998. Despite limited literature on the topic, the speaker highlights its distinctive clinical presentation characterized by yellow or white patches on the nail plate and associated histopathological features of clumped hyphae. Notably, the treatment strategies for dermatophytomas differ from typical onychomycosis; while oral terbinofine shows a low cure rate for dermatophytomas, topical treatments like ethinoconazole appear significantly more effective. The use of dermoscopy assists in distinguishing dermatophytomas from other fungal nail infections. The speaker reviewed cases and found that dermatophytomas often involve higher rates of non-dermatophyte molds, suggesting a unique treatment approach is necessary. The conclusion emphasizes that effective identification and treatment of dermatophytomas can lead to better patient outcomes, with a notable recommendation that topical therapies are usually preferable over oral medications.
View moreConclusions
- Dramatophytoma is a distinctive form of onychomycosis that requires different treatment compared to typical cases.
- Dermatophytoma appears as yellow streaks or patches on the nail plate, distinguishing it clinically from other onychomycosis cases.
- Histopathological examination reveals clustered hyphae in mycelial aggregations, which are characteristic of dermatophytomas.
- Dermoscopic evaluation is effective in differentiating dermatophytomas from non-dermatophyte molds, showing notable differences in color and nail plate involvement.
- Culture and PCR tests indicate higher rates of non-dermatophyte molds in dermatophytomas, which is significant for diagnosis.
- Topical treatments like efinaconazole are found to be more effective for dermatophytomas compared to oral therapies such as terbinafine, which show lower cure rates.
- Overall, while dermatophytomas can resolve with topical treatments, oral treatments tend to have lower success rates.
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- Miller RC, Curtis KL, Magro CM, Lipner SR, et al. "Dermatophytoma Histopathology." Under review.
- Lipner SR, et al. "J Am Podiatr Med Assoc." 2024. In Press.
- Aly R et al. "Topical Treatment of Dermatophytomas." J Drugs Dermatol. 2018 Mar 1;17(3):347-354.
- Wang et al. "Skin Appendage Disord" 2019;5:304-308.