{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T17:46:28Z","timestamp":1791740788509,"version":"4.3.4"},"reference-count":64,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Cutan Med Surg"],"abstract":"<jats:p>Onychomycosis is a chronic nail fungal infection that represents the most prevalent nail disorder encountered in clinical practice. If left untreated, it can lead to progressive nail dystrophy, localized pain and significant psychosocial impact. Management of onychomycosis is inherently challenging due to the need for prolonged therapies and a high rate of recurrence. Solid organ transplant recipients are particularly susceptible to onychomycosis due to lifelong immunosuppression. This population faces unique therapeutic challenges, including drug\u2013drug interactions between anti-rejection therapies and systemic antifungal agents. These complexities are further exacerbated by the lack of standardized treatment guidelines for this demographic. This narrative review explores the epidemiology, aetiology, diagnosis and management of onychomycosis in solid organ transplant recipients. Emphasis is placed on the complexities of balancing effective antifungal therapy with immunosuppressive regimens, as well as the need for tailored treatment protocols to optimize outcomes in this vulnerable population.<\/jats:p>","DOI":"10.1177\/12034754261488396","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T11:56:08Z","timestamp":1791460568000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Onychomycosis in Solid Organ Transplant Recipients"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2703-7594","authenticated-orcid":false,"given":"Rose","family":"He","sequence":"first","affiliation":[{"name":"Cumming School of Medicine, University of Calgary, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7782-6888","authenticated-orcid":false,"given":"P. R\u00e9gine","family":"Mydlarski","sequence":"additional","affiliation":[{"name":"Division of Dermatology, University of Calgary, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9267-3557","authenticated-orcid":false,"given":"Fatemeh","family":"Jafarian","sequence":"additional","affiliation":[{"name":"Division of Dermatology, University of Calgary, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,8]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.13677"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11046-024-00909-3"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2009.05.004"},{"key":"e_1_3_2_5_2","unstructured":"Canadian Institute for Health Information. Organ Replacement in Canada: CORR Annual Statistics. Canadian Institute for Health Information; 2024. Accessed July 20 2025. https:\/\/www.cihi.ca\/en\/organ-replacement-in-canada-corr-annual-statistics"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2018.05.1260"},{"key":"e_1_3_2_7_2","unstructured":"Canadian Institute for Health Information. Summary Statistics on Organ Transplants Wait-Lists and Donors. Canadian Institute for Health Information; 2025. Accessed July 25 2025. https:\/\/www.cihi.ca\/en\/summary-statistics-on-organ-transplants-wait-lists-and-donors"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfp486"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1159\/000475674"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1067\/s0190-9622(03)00861-2"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.1987.tb07490.x"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1590\/abd1806-4841.20131859"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdin.2021.06.002"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1439-0507.1999.00405.x"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13220"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.19644"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13544"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-199903000-00003"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.1988.tb02587.x"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1097\/HC9.0000000000000216"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2014.09.036"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.21037\/jtd-2021-26"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofad478"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1086\/651262"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0239648"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1529-8019.2002.01522.x"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.16394"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1177\/1203475417733461"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.637216"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.20471\/acc.2018.57.04.15"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0190-9622(99)70047-2"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2710.2009.01107.x"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1111\/myc.12072"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1111\/tid.13830"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.abd.2021.05.014"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1111\/tid.12799"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13212"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-6143.2002.20716.x"},{"key":"e_1_3_2_39_2","unstructured":"American Academy of Dermatology Association. Choosing Wisely: Recommendations About Treatments Tests and Procedures. American Academy of Dermatology Association. 2026. Accessed May 7 2026. https:\/\/www.aad.org\/member\/clinical-quality\/clinical-care\/wisely"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0041-1345(02)03001-4"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1592\/phco.26.12.1730"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.coph.2015.07.002"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-019-01127-8"},{"key":"e_1_3_2_44_2","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms12081619"},{"key":"e_1_3_2_45_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0190-9622(98)70486-4"},{"key":"e_1_3_2_46_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.318.7190.1031"},{"key":"e_1_3_2_47_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mycmed.2018.09.003"},{"key":"e_1_3_2_48_2","doi-asserted-by":"publisher","DOI":"10.4103\/0378-6323.158634"},{"key":"e_1_3_2_49_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2012.04584.x"},{"key":"e_1_3_2_50_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2009.04.062"},{"key":"e_1_3_2_51_2","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.138.3.353"},{"key":"e_1_3_2_52_2","doi-asserted-by":"publisher","DOI":"10.1111\/dth.14014"},{"key":"e_1_3_2_53_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468-3083.2001.00206.x"},{"key":"e_1_3_2_54_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2133.2003.05381.x"},{"key":"e_1_3_2_55_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2230.1992.tb00278.x"},{"key":"e_1_3_2_56_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2004.00988.x"},{"key":"e_1_3_2_57_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2007.07974.x"},{"key":"e_1_3_2_58_2","doi-asserted-by":"publisher","DOI":"10.1111\/dth.12545"},{"key":"e_1_3_2_59_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000017948"},{"issue":"20","key":"e_1_3_2_60_2","first-page":"3697","article-title":"Effects of laser irradiation on Trichophyton rubrum growth and ultrastructure","volume":"125","author":"Xu ZL","year":"2012","unstructured":"Xu ZL, Xu J, Zhuo FL, et al. Effects of laser irradiation on Trichophyton rubrum growth and ultrastructure. Chin Med J (Engl). 2012;125(20):3697-3700.","journal-title":"Chin Med J (Engl)"},{"key":"e_1_3_2_61_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.15660"},{"key":"e_1_3_2_62_2","doi-asserted-by":"publisher","DOI":"10.5021\/ad.2017.29.6.699"},{"key":"e_1_3_2_63_2","doi-asserted-by":"publisher","DOI":"10.34172\/jlms.2023.35"},{"key":"e_1_3_2_64_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2008.12.012"},{"key":"e_1_3_2_65_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13047-019-0332-3"}],"container-title":["Journal of Cutaneous Medicine and Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/12034754261488396","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/12034754261488396","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/12034754261488396","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T17:06:51Z","timestamp":1791738411000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/12034754261488396"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,8]]},"references-count":64,"alternative-id":["10.1177\/12034754261488396"],"URL":"https:\/\/doi.org\/10.1177\/12034754261488396","relation":{},"ISSN":["1203-4754","1615-7109"],"issn-type":[{"value":"1203-4754","type":"print"},{"value":"1615-7109","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,8]]},"article-number":"12034754261488396"}}