Soyun Cho, Hanjae Lee, Ji Ye Hwang, Jong Soo Choi, Hyeong Jik Kim, Tae Woo Kim, Seung-Baik Kang
DOI: 10.2340/00015555-3895

Knee disorders that compromise patients’ lower leg movements and self-care may put these patients at greater risk of onychomycosis. However, little is known about the prevalence of onychomycosis in patients with knee diseases. This study evaluated the prevalence and characteristics of onychomycosis in patients with knee osteoarthritis. A total of 520 consecutive patients with symptomatic knee osteoarthritis who visited the Department of Orthopedics for a potential knee surgery were evaluated for onychomycosis by PCR-based reverse blot hybridization assay. Of the 520 patients, 308 (59.2%) were diagnosed with onychomycosis. Age (p = 0.004), male sex (p = 0.015), and being barefooted (p = 0.031) were statistically significant risk factors for onychomycosis. Knee disease severity, based on Kellgren-Lawrence grade, was associated with severity of onychomycosis. The impairment of physical function and self-care caused by knee disorders may increase the prevalence of onychomycosis in these patients.

Onychomycosis is a common nail disease that can inflict a huge medical burden, especially in elderly individuals. However, onychomycosis is often considered trivial and underestimated. In this study, onychomycosis was diagnosed in more than half of the patients with symptomatic knee osteoarthritis. As life expectancy increases globally and chronic diseases, including knee osteoarthritis, become more prevalent, the close association of onychomycosis, both in prevalence and severity, with osteoarthritis, warrants a careful multidisciplinary approach, since early diagnosis and treatment leads to lower patient morbidity and medical costs.