{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T20:42:45Z","timestamp":1778791365823,"version":"3.51.4"},"reference-count":26,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,7,24]],"date-time":"2023-07-24T00:00:00Z","timestamp":1690156800000},"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":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:label\/><jats:p>Onychomycosis is common among immunosuppressed individuals. Renal transplant recipients (RTR) and lupus nephritis (LN) patients are submitted to corticosteroid and other immunosuppressive therapy; and diabetes mellitus (DM) patients are intrinsically immunocompromised.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The aim of this study was to characterise and identify fungal infections on the nails (feet and hands) in immunocompromised patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The clinical material, nail scales (foot and\/or hand), was collected from 47 RTR, 66 LN, 67 DM, and 78 immunocompetent individuals (control group). Phenotypic and molecular analyses were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 258 patients were examined. There was a female predominance, except in the RTR. The average age was 52\u2009years old. Lateral distal subungual onychomycosis (OSDL) (75.2%), mainly affecting the hallux nail, was frequent. The predominance of dermatophyte on toenails and <jats:italic>Candida<\/jats:italic> species on fingernails was statistically significant. A higher frequency of fingernail involvement in LN and DM, and for LN, the difference was significant (<jats:italic>p<\/jats:italic>\u2009=\u2009.0456). Infections by <jats:italic>Candida<\/jats:italic> spp. were more frequent in DM. Using molecular methods, 87.2% of diagnoses were confirmed, identifying fungal agents at the species level. Dermatophytes, <jats:italic>Trichophyton rubrum<\/jats:italic> and <jats:italic>Trichophyton interdigitale<\/jats:italic> and the species of <jats:italic>Candida<\/jats:italic>, <jats:italic>C. parapsilosis<\/jats:italic> and <jats:italic>C. albicans<\/jats:italic>, were the most frequent fungal agents.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Molecular techniques (sequencing of ITS regions of rDNA) offer greater accuracy, although there is no difference, regarding the detection. Clinical presentation and fungal species may differ somewhat from the general population. Immunosuppression did not increase fungal detection positivity.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.13634","type":"journal-article","created":{"date-parts":[[2023,7,25]],"date-time":"2023-07-25T03:29:41Z","timestamp":1690255781000},"page":"1018-1024","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Onychomycosis in immunocompromised population: Phenotypic and molecular identification"],"prefix":"10.1111","volume":"66","author":[{"given":"Orion Sant\u2019Anna Motter","family":"Borba","sequence":"first","affiliation":[{"name":"Program in Translational Medicine, Department of Medicine, Laboratory of Cellular Biology, Escola Paulista de Medicina Universidade Federal de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marilia Marufuji","family":"Ogawa","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Hospital S\u00e3o Paulo, Escola Paulista de Medicina Universidade Federal de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianna Mastroianni","family":"Kirsztajn","sequence":"additional","affiliation":[{"name":"Discipline of Nephrology, Hospital S\u00e3o Paulo, Escola Paulista de Medicina Universidade Federal de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2407-6646","authenticated-orcid":false,"given":"Jane","family":"Tomimori","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Hospital S\u00e3o Paulo, Escola Paulista de Medicina Universidade Federal de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,7,24]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12281-017-0292-7"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3062.2010.00568.x"},{"key":"e_1_2_9_4_1","first-page":"1600","volume-title":"Atlas of Clinical Fungi","author":"Hoog GS","year":"2019"},{"key":"e_1_2_9_5_1","first-page":"82","article-title":"Use of single\u2010 enzyme PCR\u2010restriction digestion barcode targeting the internal transcribed spacers (ITS r DNA) to identify dermatophyte species","volume":"41","author":"Rezaei\u2010Matehkolaei A","year":"2012","journal-title":"Iran J Public 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