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Onychomycosis and Quality of Life
1. Sikora M, Pacholek T, Soter K, Szepietowski J, Analysis of Dermatol Venereol, 2002;16(Suppl. 1):248. 22. Reich A, Nowicka D, Szepietowski J, Quality of life among
fungal skin and skin appendages infections in the region 12. Millikan LE, Powell DW, Drake LA, Quality of life for young men suffering from androgenetic alopecia,
of Wroclaw in the years 1995–1999, Mikol Lek, 2000;7: patients with onychomycosis, Int J Dermatol, Dermatol Klin, 2005;7:79–81.
145–51. 1999;38(Suppl. 2):13–16. 23. Warshaw EM, Foster JK, Cham PMH, et al., NailQoL: a
2. Roberts DT, Prevalence of dermatophyte onychomycosis 13. Shaw JW, Joish VN, Coons SJ, Onychomycosis: quality-of-life instrument for onychomycosis, Int J
in the United Kingdom: results of an omnibus survey, Br J Health-related quality of life considerations, Dermatol, 2007;46:1279–86.
Dermatol, 1992;126:23–37. Pharmacoeconomics, 2002;20:23–36. 24. Elewski BE, The effect of toenail onychomycosis on
3. Heikkilä H, Stubb S, The prevalence of onychomycosis in 14. Szepietowski JC, Reich A, Wozniak M, Baran E, Evaluation patient quality of life, Int J Dermatol, 1997;36:754–6.
Finland, Br J Dermatol, 1995;133:699–701. of quality of life in patients with onychomycosis using the 25. Szepietowski JC, Reich A; for the National Quality of Life in
4. Gupta AK, Jain HC, Lynde CW, et al., Prevalence and Polish version of Dermatology Life Quality Index, Mikol Dermatology Group, Stigmatisation in onychomycosis
epidemiology of unsuspected onychomycosis in patients Lek, 2006;13:193–8. patients: a population-based study, Mycoses, 2008 Sep 12
visiting dermatologists’ offices in Ontario, Canada—a 15. Szepietowski JC, Reich A, Pacan P, et al., Evaluation of [Epub ahead of print]
multicenter survey of 2001 patients, Int J Dermatol, quality of life in patients with toenail onychomycosis by 26. Katsambas A, Abeck D, Haneke E, et al., The effects of foot
1997;36:783–7. Polish version of an international onychomycosis-specific disease on quality of life: results of the Achilles Project,
5. Szepietowski JC, Reich A, Garlowska E, et al., Factors questionnaire, J Eur Acad Dermatol Venerol, 2007;21: J Eur Acad Dermatol Venereol, 2005;19:191–5.
influencing coexistence of toenail onychomycosis with 491–6. 27. Drake LA, Patrick DL, Fleckman P, et al., The impact of
tinea pedis and other dermatomycoses: a survey of 2761 16. Lubeck DP, Patrick DL, McNulty P, et al., Quality of life of onychomycosis on quality of life: development of an
patients, Arch Dermatol, 2006;142:1279–84. persons with onychomycosis, Qual Life Res, 1993;2:341–8. international onychomycosis-specific questionnaire to
6. Roberts DT, Onychomycosis: current treatment and future 17. Lubeck DP, Measuring health-related quality of life in measure patient quality of life, J Am Acad Dermatol,
challenges, Br J Dermatol, 1999;141(Suppl. 56):1–4. onychomycosis, J Am Acad Dermatol, 1998;38:S64–S68. 1999;41:189–96.
7. Szepietowski JC, Selected clinical aspects of 18. Finlay AY, Khan GK, Dermatology Life Quality Index (DLQI) – 28. Lubeck DP, Gause D, Schein JR, et al., A health-related
onychomycosis, Mikol Lek, 2004;11:119–28. a simple practical measure for routine clinical use, Clin quality of life measure for use in patients with
8. Roujeau JC, Sigurgeirsson B, Korting HC, et al., Chronic Exp Dermatol, 1994;19:210–14. onychomycosis: a validation study, Qual Life Res,
dermatomycoses of the foot as risk factors for acute 19. Hrehorów E, Reich A, Szepietowski J, Quality of life of 1999;8:121–9.
bacterial cellulitis of the leg: a case-control study, patients with psoriasis: relationship with pruritus, stress 29. Lubeck DP, Schein JR, Gause D, et al., Health-related
Dermatology, 2004;209:301–7. and symptoms of depression, Dermatol Klin, 2007;9: quality of life in patients with toenail onychomycosis: data
9. Arrese JE, Piérard-Franchimont C, Piérard GE, Fatal 19–23. from 9-month observational study, J Clin Outcomes
hyalohyphomycosis following Fusarium onychomycosis in 20. Reich A, Chrostowska-Plak D, Szepietowski JC, The Manage, 1999;6:37–42.
an immunocompromised patient, Am J Dermatopathol, influence of itching on atopic dermatitis patients’ 30. Turner RR, Testa MA, Measuring the impact of
1996;18:196–8. well-being, Acta Derm Venereol, 2007;87:471–2. onychomycosis on patient quality of life, Qual Life Res,
10. Drake LA, Scher RK, Smith EB, et al., Effect of 21. Szepietowski JC, Reich A, Wesolowska-Szepietowska E, 2000;9:39–53.
onychomycosis on quality of life, J Am Acad Dermatol, Baran E, Quality of life in patients suffering from 31. Firooz A, Khamesipour A, Dowlati Y, Itraconazole pulse
1998;38:702–4. seborrheic dermatitis: influence of age, gender and therapy improves the quality of life of patients with toenail
11. Kowalczuk-Zieleniec E, Nowicki E, Majkowicz M, education level, Mycoses, 2008 Sep 12 [Epub ahead onychomycosis, J Dermatol Treat, 2003;14:95–8.
Onychomycosis changes quality of life, J Eur Acad of print].
By the Same Authors
Vasoactive Peptides in the Pathogenesis of Psoriasis Stigmatisation in Onychomycosis Patients:
Reich A, Szepietowski JC, G Ital Dermatol Venereol, 2008;143:289–98.
A Population-based Study
Szepietowski JC, Reich A, National Quality of Life in Dermatology Group, Mycoses,
This article discusses psoriasis, which is a chronic inflammatory
2008 Sep 12 [Epub ahead of print].
skin disease believed to be exacerbated by stress. The authors
believe the exact mechanism of this phenomenon is not fully This article primarily reviews patients with onychomycosis and how
understood, however, it has been postulated that different they may experience significant psychosocial problems, similarly to
substances released from dermal nerve endings during stress may other skin diseases. The objective was to analyse the level of
play a role in the initiation or modulation of psoriasis. The article stigmatisation among subjects with onychomycosis and the effect
primarily discusses how the most interesting group of mediators of antimycotic therapy on this feeling. This prospective study was
are polypeptides, also known as neuropeptides, which possess carried out among 1,684 patients (1,050 women and 634 men, mean
vasoactive properties. It was documented that these polypeptides age 52.2±15.5 years) with onychomycosis. All subjects were asked to
could not only be released from nerve endings, but may also be complete the stigmatisation questionnaire at the baseline visit and
directly synthesised in the skin and liberated from numerous after the completion of the anti-mycotic therapy. Stigmatisation level
dermal cells. Moreover, these substances are not only released by was assessed with reference to gender, age, education, type and
different cells, but may activate various cell types showing a wide duration of onychomycosis and the number of involved nails. The
spectrum of biological actions. study concluded that patients with onychomycosis reported an
increased feeling of stigmatisation. Fingernail involvement was the
The article concludes that this complex system of interactions major variable negatively influencing the stigmatisation level. Female
seems to be an important component of psoriatic pathological patients and younger ones appeared to be more stigmatised. No
reaction. The significant role of these neuromediators has also been significant relationships were found between stigmatisation level
postulated in other chronic skin diseases, such as palmoplantar and education. The antimycotic therapy resulted in significant
pustulosis, atopic and irritant eczema, rosacea, lichen sclerosus, reduction of all analysed aspects of stigmatisation to about 40% of
vitiligo, pigmented urticaria or prurigo nodularis. Among different the baseline level. The authors concluded that onychomycosis
neuropeptides, substance P, calcitonin-gene-related peptide, should be considered as an important problem for patients, as it
vasoactive intestinal peptide (VIP) and neuropeptide Y have been significantly reduces their physical, mental and social wellbeing.
mainly studied in psoriasis. ■ which in turn leads to marked stigmatisation of patients. ■
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