{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T19:39:07Z","timestamp":1792697947928,"version":"4.5.0"},"reference-count":125,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T00:00:00Z","timestamp":1712880000000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Onychomycosis is a chronic nail disorder commonly seen by healthcare providers; toenail involvement in particular presents a treatment challenge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To provide an updated estimate on the prevalence of toenail onychomycosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a literature search using PubMed, Embase and Web of Science. Studies reporting mycology\u2010confirmed diagnoses were included and stratified into (a)\n                      <jats:italic>populations\u2010based<\/jats:italic>\n                      studies, and studies that included (b)\n                      <jats:italic>clinically un\u2010suspected<\/jats:italic>\n                      and (c)\n                      <jats:italic>clinically suspected<\/jats:italic>\n                      patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 108 studies were included. Based on studies that examined\n                      <jats:italic>clinically un\u2010suspected<\/jats:italic>\n                      patients (i.e., with or without clinical features suggestive of onychomycosis), the pooled prevalence rate of toenail onychomycosis caused by dermatophytes was 4% (95% CI: 3\u20135) among the general population; special populations with a heightened risk include knee osteoarthritis patients (RR: 14.6 [95% CI: 13.0\u201316.5]), chronic venous disease patients (RR: 5.6 [95% CI: 3.7\u20138.1]), renal transplant patients (RR: 4.7 [95% CI: 3.3\u20136.5]), geriatric patients (RR: 4.7 [95% CI: 4.4\u20134.9]), HIV\u2010positive patients (RR: 3.7 [95% CI: 2.9\u20134.7]), lupus erythematosus patients (RR: 3.1 [95% CI: 1.2\u20136.3]), diabetic patients (RR: 2.8 [95% CI: 2.4\u20133.3]) and hemodialysis patients (RR: 2.8 [95% CI: 1.9\u20134.0]). The prevalence of onychomycosis in\n                      <jats:italic>clinically suspected<\/jats:italic>\n                      patients was significantly higher likely due to sampling bias. A high degree of variability was found in a limited number of\n                      <jats:italic>population\u2010based<\/jats:italic>\n                      studies indicating that certain pockets of the population may be more predisposed to onychomycosis. The diagnosis of non\u2010dermatophyte mould onychomycosis requires repeat sampling to rule out contaminants or commensal organisms; a significant difference was found between studies that performed single sampling versus repeat sampling. The advent of PCR diagnosis results in improved detection rates for dermatophytes compared to culture.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Onychomycosis is an underrecognized healthcare burden. Further\n                      <jats:italic>population\u2010based<\/jats:italic>\n                      studies using standardized PCR methods are warranted.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/myc.13725","type":"journal-article","created":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T08:13:49Z","timestamp":1712909629000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Global prevalence of onychomycosis in general and special populations: An updated perspective"],"prefix":"10.1111","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8664-7723","authenticated-orcid":false,"given":"Aditya K.","family":"Gupta","sequence":"first","affiliation":[{"name":"Division of Dermatology, Department of Medicine University of Toronto School of Medicine  Toronto Ontario Canada"},{"name":"Mediprobe Research Inc.  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