แนวคิดหลัก
Patients with onychodystrophy who have a history of tinea pedis, chronic kidney disease, peripheral vascular disease, or type 2 diabetes are at an increased risk of having onychomycosis.
บทคัดย่อ
This retrospective case-control study aimed to identify factors associated with histopathologically confirmed onychomycosis in patients with onychodystrophy. The researchers evaluated data on 1256 patients with onychodystrophy seen at Weill Cornell Medicine from January 2013 to October 2020.
Key findings:
Overall, 47% of patients had onychomycosis.
Tinea pedis (odds ratio [OR], 10.3), chronic kidney disease (OR, 2.3), peripheral vascular disease (OR, 2.1), and type 2 diabetes (OR, 1.6) were associated with a significantly increased risk for onychomycosis.
Tinea pedis (OR, 11.4) and peripheral vascular disease (OR, 1.9) were positive predictors of onychomycosis.
A history of psoriasis (OR, 0.4) and female sex (OR, 0.6) were negative predictors of onychomycosis.
The authors suggest that these findings argue against empiric treatment and may help dermatologists identify patients more likely to have onychomycosis, encouraging appropriate testing and antifungal stewardship.
สถิติ
Patients with onychodystrophy who have a history of tinea pedis have a 10.3-fold increased risk of having onychomycosis.
Patients with onychodystrophy who have chronic kidney disease have a 2.3-fold increased risk of having onychomycosis.
Patients with onychodystrophy who have peripheral vascular disease have a 2.1-fold increased risk of having onychomycosis.
Patients with onychodystrophy who have type 2 diabetes have a 1.6-fold increased risk of having onychomycosis.
Patients with onychodystrophy who have a history of psoriasis have a 0.4-fold (or 60% lower) risk of having onychomycosis.
Patients with onychodystrophy who are female have a 0.6-fold (or 40% lower) risk of having onychomycosis.
คำพูด
"The results 'argue against empiric treatment, as visual examination and patient-level factors may not reliably indicate onychomycosis,' the authors wrote, 'and may help dermatologists identify patients more likely to have onychomycosis, encouraging appropriate testing and antifungal stewardship.'"