Onychomycosis in children

Figures & data

Figure 1. Tinea pedis plantaris ‘mocassin type’ in an 8-year-old girl with Trichophyton rubrum onychomycosis.

Mild erythema and scaling.

Figure 2. Distal subungual onychomycosis caused by Trichophyton rubrum in a 7-year-old boy: lateral onycholysis and mild subungual hyperkeratosis can be seen.

Figure 3. White superficial onychomycosis ‘classic type’ due to Trichophyton interdigitale in a 12-year-old boy: superficial white nail fragility caused by fungal colonies can be seen.

Figure 4. White superficial onychomycosis ‘deep’ caused by Trichophyton interdigitale in a 6-year-old boy: the nail plate is diffusely white and opaque due to massive fungal invasion.

Figure 5. Distal subungual onychomycosis caused by Candida in a newborn: onycholysis and subungual hyperkeratosis with yellow discoloration of several fingernails.

Figure 6. Congenital malalignment of the great toenails with distal onycholysis and subungual hyperkeratosis.

Differential diagnosis with distal subungual onychomycosis requires mycology.

Figure 7. Pachyonychia congenita.

Nail lesions in a 7-year-old boy. All nails show mild thickening with distal onycholysis and subungual hyperkeratosis.

Figure 8. Traumatic onycholysis of the left toenail in a 12-year-old girl: the subungual space is white and there is no hyperkeratosis.

Figure 9. Nail psoriasis of the fourth left fingernail in a 5-year-old girl.

Diffuse crumbling of the nail plate.

Figure 10. Nail psoriasis of the third right toenail.

Onycholysis with erythematous border and splinter hemorrhages.

Figure 11. Parakeratosis pustulosa.

A single fingernail showing mild subungual hyperkeratosis and onycholysis, associated with periungual scaling. Note traumatic punctate leukonychia of the fifth fingernail.

Figure 12. Subungual exostosis of the fourth right toenail in a 13-year-old boy who played soccer: the subungual mass uplifts the nail plate.

Figure 13. Subungual wart of the fifth right fingernail in a 7-year-old girl: subungual scales uplift and detach the distal nail plate and resemble distal subungual onychomycosis.

Figure 14. Punctate leukonychia in the fingernails of an 8-year-old boy: small white spots within the nail plate that has a normal surface.

Figure 15. Nail fragility in an 8-month-old child: the distal nail plate is broken with sharp margins.

Figure 16. Paronychia due to finger sucking of two fingers in a 1-year-old boy: swelling and mild erythema of the proximal nail folds, absent cuticles and an irregular nail plate surface can be seen.

Isolation of Candida indicates secondary colonization and not primary invasion.

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