{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T05:34:50Z","timestamp":1777613690286,"version":"3.51.4"},"reference-count":21,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2020,7,4]],"date-time":"2020-07-04T00:00:00Z","timestamp":1593820800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Candida onychomycosis mostly involves fingernails. Yet, in contrast to dermatophytes, Candida isolation from dystrophic fingernails does not prove casualty, as sample contamination and non\u2010pathogenic Candida growth occur. Characterising treatment outcome of Candida\u2010positive dystrophic nails is crucial to avoid unnecessary treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate predicators associated with treatment outcome among Candida\u2010positive dystrophic fingernails.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and methods<\/jats:title><jats:p>A retrospective cohort study was carried out among 108 adults with Candida\u2010positive dystrophic fingernails not cured with adequate systemic anti\u2010fungal course. Diagnosis was based on a single mycological culture. Patients with treatment failure (n\u00a0=\u00a085; 78.7% of the cases) were compared to patients with partial response (mild to almost cure; n\u00a0=\u00a023; 21.3% of the cases) at 9 to 12\u00a0months following treatment initiation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Treatment failure was significantly associated with primary onycholysis (odds ratio [OR] 2.8; 95% confidence interval [CI] 1.1\u20107.4) and prolonged dystrophy (12.8 vs. 3.7\u00a0years in average), compared to partial treatment response. Non\u2010responders had lower odds to present with distal lateral subungual onychomycosis, compared to partial responders (OR 0.3; 95% CI 0.1\u20100.7). Demographic and mycological characteristics, as well as number of nails affected, co\u2010presence of paronychia, and treatment regime were not found to be associated with treatment response.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Candida\u2010positive primary onycholysis was shown to be non\u2010responsive to systemic anti\u2010fungal treatment, suggesting that anti\u2010fungal treatment is not indicated. For other clinical scenarios, high proportions of treatment non\u2010response suggest that determining causality of Candida should not be based on a single positive mycological culture.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.13133","type":"journal-article","created":{"date-parts":[[2020,6,20]],"date-time":"2020-06-20T21:24:45Z","timestamp":1592688285000},"page":"964-969","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Clinical significance of Candida isolation from dystrophic fingernails"],"prefix":"10.1111","volume":"63","author":[{"given":"Avner","family":"Shemer","sequence":"first","affiliation":[{"name":"Department of Dermatology Sheba Medical Center Ramat\u2010Gan Israel"},{"name":"Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ralph","family":"Daniel","sequence":"additional","affiliation":[{"name":"University of Mississippi Medical Center Jackson MS USA"},{"name":"University of Alabama Birmingham AL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Lyakhovitsky","sequence":"additional","affiliation":[{"name":"Department of Dermatology Sheba Medical Center Ramat\u2010Gan Israel"},{"name":"Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vered","family":"Aghion\u2010Svirsky","sequence":"additional","affiliation":[{"name":"Department of Dermatology Sheba Medical Center Ramat\u2010Gan Israel"},{"name":"Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Riad","family":"Kassem","sequence":"additional","affiliation":[{"name":"Department of Dermatology Sheba Medical Center Ramat\u2010Gan Israel"},{"name":"Sackler Faculty of Medicine Tel Aviv University Tel Aviv 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