Chronic venous insufficiency associated to subclinical onychomycosis

Abstract

Background: Onychomycosis (OM) and peripheral vascular insufficiency (PVI) are both frequent ailments that share risk factors such as genetic susceptibility, longevity, microvascular alterations, among others. Previous studies have found an association between them, but none has addressed the relation between the vascular disease and subclinical onychomycosis. Objective: To identify patients with fungal nail invasion and clinically healthy appearing nails. Methods: We included 30 toenail clippings of patients with PVI and clinically healthy appearing nails, processed them in paraffin and PAS stain. These samples were analyzed by an expert dermatopathologist, in search of fungal structures. Results: Fungal structures invading the nail plate were identified in 10 samples (33.3%). Study limitations this was a pilot study, so the numer of participants is small. Conclusion: A strong connection existes between these two diseases, even though we didn´t find relation between the presence of fungal structures and the severity of PVI. Previous studies have reported this on clinically evident OM, and now this data in subclinical OM adds up. This field still has many unanswered questions, providing an excellent study opportunity in search of the initial stages of onychomycosis.