Frequency of peripheral arterial disease and venous insufficiency in toenail onychomycosis

Onychomycosis in toenails is a common fungal infection and vascular abnormalities of lower extremities have been thought as one of the predisposing conditions. The aim of this study was to evaluate predisposition effect of venous insufficiency and peripheral arterial disease on toenail onychomycosis. Thirty‐three patients with bilateral onychomycosis in toenails and 37 control subjects, who had healthy nails, were enrolled in the study. Veins and arteries of lower extremities were examined with Doppler ultrasound in terms of venous insufficiency or peripheral arterial disease. Patients with onychomycosis presented more frequent venous insufficiency than the control group (42.4% and 10.8%, respectively; P = 0.003). Although all patients had bilateral onychomycosis, reflux was bilateral in six out of 14 patients with onychomycosis (42.8%). No significant difference in frequency of peripheral arterial disease was found in patients, compared to healthy controls. Our study demonstrated a significant relationship between onychomycosis and venous insufficiency, but not with peripheral arterial disease. Also, we point out discordance with bilateral onychomycosis and unilateral venous insufficiency.

[1]  F. Zaccagna,et al.  Peripheral arterial occlusive disease: diagnostic performance and effect on therapeutic management of 64-section CT angiography. , 2011, Radiology.

[2]  Gregory M. Peterson,et al.  Toenail onychomycosis: an important global disease burden , 2010, Journal of clinical pharmacy and therapeutics.

[3]  G. Meneilly,et al.  Short-Term Aerobic Exercise Reduces Arterial Stiffness in Older Adults With Type 2 Diabetes, Hypertension, and Hypercholesterolemia , 2009, Diabetes Care.

[4]  J. Takeda,et al.  Higher arterial stiffness, greater peripheral vascular resistance and lower blood flow in lower‐leg arteries are associated with long‐term hyperglycaemia in type 2 diabetic patients with normal ankle‐brachial index , 2009, Diabetes/metabolism research and reviews.

[5]  S. Morikawa,et al.  Impaired peripheral circulation in lower-leg arteries caused by higher arterial stiffness and greater vascular resistance associates with nephropathy in type 2 diabetic patients with normal ankle-brachial indices. , 2008, Diabetes research and clinical practice.

[6]  H. Trau,et al.  Toenail abnormalities and onychomycosis in chronic venous insufficiency of the legs: should we treat? , 2008, Journal of the European Academy of Dermatology and Venereology : JEADV.

[7]  R. Petrella,et al.  Acute and Chronic Impact of Dynamic Exercise on Arterial Stiffness in Older Hypertensives , 2008, The open cardiovascular medicine journal.

[8]  A. Bradbury,et al.  Transition of care in children with chronic disease , 2007, BMJ : British Medical Journal.

[9]  G. Moneta Peripheral Arterial Disease: Comparison of Color Duplex US and Contrast-enhanced MR Angiography for Diagnosis , 2007 .

[10]  L. Norgren,et al.  Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). , 2007, Journal of vascular surgery.

[11]  M. Arendrup,et al.  Prevalence of toe nail onychomycosis in diabetic patients. , 2006, Acta dermato-venereologica.

[12]  M. Acar,et al.  Venous Insufficiency in Patients With Toenail Onychomycosis , 2005, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[13]  J. V. van Engelshoven,et al.  Peripheral arterial disease: comparison of color duplex US and contrast-enhanced MR angiography for diagnosis. , 2005, Radiology.

[14]  N. Labropoulos,et al.  Duplex evaluation of venous insufficiency. , 2005, Seminars in vascular surgery.

[15]  R. Arenas,et al.  Frequency of toenail onychomycosis in patients with cutaneous manifestations of chronic venous insufficiency , 2001, International journal of dermatology.

[16]  R. Summerbell,et al.  The epidemiology of onychomycosis: possible role of smoking and peripheral arterial disease , 2000, Journal of the European Academy of Dermatology and Venereology : JEADV.

[17]  R. Summerbell,et al.  Prevalence and epidemiology of toenail onychomycosis in diabetic subjects: a multicentre survey , 1998, The British journal of dermatology.

[18]  R. Rutherford,et al.  Recommended standards for reports dealing with lower extremity ischemia: revised version. , 1997, Journal of vascular surgery.

[19]  G. Moneta,et al.  Ability of ankle-brachial index to detect lower-extremity atherosclerotic disease progression. , 1997, Archives of surgery.