{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T20:19:53Z","timestamp":1788121193759,"version":"build-2803163510"},"reference-count":14,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T00:00:00Z","timestamp":1736208000000},"content-version":"vor","delay-in-days":6,"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":[[2025,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Few ex\u00a0vivo studies have investigated the virulence factors of fungi causing onychomycosis. The effect of nail polish in predisposing or protecting against onychomycosis remains debatable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>This ex\u00a0vivo study aimed to identify the nail invasion ability of dermatophytes, non\u2010dermatophytes and yeast, with and without nail polishing, in the nails of young and elderly individuals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Six fungal species were tested: dermatophytes (<jats:italic>Trichophyton rubrum<\/jats:italic>, <jats:italic>T. mentagrophytes<\/jats:italic>, <jats:italic>Microsporum canis<\/jats:italic>), non\u2010dermatophytes (<jats:italic>Neoscytalidium dimidiatum<\/jats:italic>, <jats:italic>Fusarium<\/jats:italic> spp.) and <jats:styled-content style=\"fixed-case\"><jats:italic>Candida albicans<\/jats:italic><\/jats:styled-content>. Nail plates from eight volunteers (four aged \u2265\u200970\u2009years; four aged &lt;\u200970\u2009years) were divided into polished and non\u2010polished groups, incubated with each fungus and evaluated at 2, 4 and 8\u2009weeks. Positive results were determined the presence of fungal hyphae or pseudohyphae penetrating the nail plate, with the enlargement of invasive fungal elements confirmed by histology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At 2\u2009weeks, <jats:italic>N. dimidiatum<\/jats:italic> exhibited the highest nail invasion rate (15\/16, 93.75%), whereas <jats:styled-content style=\"fixed-case\"><jats:italic>C. albicans<\/jats:italic><\/jats:styled-content> showed the lowest (1\/16, 6.25%). Fungal penetration into nail plates increased with longer incubation durations. At 8\u2009weeks, <jats:styled-content style=\"fixed-case\"><jats:italic>C. albicans<\/jats:italic><\/jats:styled-content> did not invade any polished nail plates; however, the difference in invasion rates between polished and unpolished nail plates was not statistically significant. Additionally, age did not significantly affect the invasion of most fungi in this ex\u00a0vivo study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This ex\u00a0vivo study supported the concept that fungal virulence is the main determining factor for nail invasion. <jats:italic>N. dimidiatum<\/jats:italic> caused the most and fastest nail plate penetration. Nail polishing may slow the penetration of low\u2010virulence organisms.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.70019","type":"journal-article","created":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T05:37:36Z","timestamp":1736314656000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Ex Vivo Fungal Nail Penetration Study: Effects of Causative Organisms, Nail Polish and Age"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4349-3776","authenticated-orcid":false,"given":"Kanyalak","family":"Munprom","sequence":"first","affiliation":[{"name":"Department of Dermatology, Faculty of Medicine Siriraj Hospital Mahidol University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0852-7742","authenticated-orcid":false,"given":"Sumanas","family":"Bunyaratavej","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Faculty of Medicine Siriraj Hospital Mahidol University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3293-7813","authenticated-orcid":false,"given":"Penvadee","family":"Pattanaprichakul","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Faculty of Medicine Siriraj Hospital Mahidol University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0928-5650","authenticated-orcid":false,"given":"Pattriya","family":"Jirawattanadon","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Faculty of Medicine Siriraj Hospital Mahidol University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9311-598X","authenticated-orcid":false,"given":"Lalita","family":"Matthapan","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Faculty of Medicine Siriraj Hospital Mahidol University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7808-7001","authenticated-orcid":false,"given":"Waranyoo","family":"Prasong","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Faculty of Medicine Siriraj Hospital Mahidol University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5066-9621","authenticated-orcid":false,"given":"Chatisa","family":"Panyawong","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Faculty of Medicine Siriraj Hospital Mahidol University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0106-9077","authenticated-orcid":false,"given":"Akkarapong","family":"Plengpanich","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Faculty of Medicine Siriraj Hospital Mahidol University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8430-376X","authenticated-orcid":false,"given":"Charussri","family":"Leeyaphan","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Faculty of Medicine Siriraj Hospital Mahidol University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,1,7]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/jof9070712"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/1346-8138.12768"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13575"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mycmed.2021.101165"},{"key":"e_1_2_8_6_1","first-page":"659","article-title":"Prevalence, Risk Factors, and Type of Organism in Fungal Foot Infection and Toenail Onychomycosis in Thai Diabetic Patients","volume":"99","author":"Assadamongkol R.","year":"2016","journal-title":"Journal of the Medical Association of Thailand"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijd.IJD_395_20"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1590\/abd1806-4841.20187791"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/8519376"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajd.13686"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjid.2013.08.005"},{"key":"e_1_2_8_12_1","first-page":"124","article-title":"Comparison of Patient and Clinical Differences Between Superficial Skin Infections due to Microsporum canis and Trichophyton rubrum","volume":"51","author":"Bunyaratavej S.","year":"2020","journal-title":"Southeast Asian Journal of Tropical Medicine and Public 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