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A summary of the epidemiological impact, antifungal treatment options, special considerations for at\u2010risk subpopulations, and methods to prevent infection and recurrence are discussed. A systematic review of available epidemiological studies found the worldwide prevalence of culture\u2010confirmed pediatric toenail onychomycosis to be 0.33%, with no significant increases in prevalence over time. A systematic review of studies investigating the efficacy of various antifungals in treating pediatric onychomycosis found high cure rates and low frequency of adverse events with systemic itraconazole and terbinafine; however, the studies are few, dated, and lack impact because of small sample sizes. Comparatively, clinical trials implementing FDA\u2010approved topical antifungal treatments report slightly reduced cure rates with larger sample sizes. Patients with immunity\u2010altering conditions, such as Down's syndrome, or those immunosuppressed because of chemotherapy or HIV\/AIDS are at a greater risk of onychomycosis infection and require special consideration with treatment. Proper sanitization and hygiene practices are necessary to reduce the risk of acquiring infection. Early diagnosis and treatment of onychomycosis in children, as well as any affected close contacts, are crucial in reducing the impact of the disease.<\/jats:p>","DOI":"10.1111\/ijd.17495","type":"journal-article","created":{"date-parts":[[2024,9,19]],"date-time":"2024-09-19T05:11:13Z","timestamp":1726722673000},"page":"465-472","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Pediatric dermatophyte onychomycosis: a review"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8664-7723","authenticated-orcid":false,"given":"Aditya K.","family":"Gupta","sequence":"first","affiliation":[{"name":"Division of Dermatology, Temerty Faculty of Medicine University of Toronto  Toronto ON Canada"},{"name":"Mediprobe Research Inc.  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