Onychomycosis Endonyx: A Systematic Review

Background/Objectives: Endonyx onychomycosis is a chronic infection of the nail plate that presents as milky white discoloration, without hyperkeratosis or onycholysis, and was originally described as being caused by <i>T. soudanense</i> and <i>T. violaceum</i>. Methods: In t...

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Main Authors: Ernesto De-La-Rosa-Garibay, Roberto Arenas, Martha Y. Herrera-Castro, Alicia Valdez-Gaona, Gabriela Moreno-Coutiño, Paola Berenice Zarate-Segura, Fernando Bastida-González, Erick Martínez-Herrera, Rodolfo Pinto-Almazán
Format: Article
Language:English
Published: MDPI AG 2025-04-01
Series:Diseases
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Online Access:https://www.mdpi.com/2079-9721/13/4/110
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author Ernesto De-La-Rosa-Garibay
Roberto Arenas
Martha Y. Herrera-Castro
Alicia Valdez-Gaona
Gabriela Moreno-Coutiño
Paola Berenice Zarate-Segura
Fernando Bastida-González
Erick Martínez-Herrera
Rodolfo Pinto-Almazán
author_facet Ernesto De-La-Rosa-Garibay
Roberto Arenas
Martha Y. Herrera-Castro
Alicia Valdez-Gaona
Gabriela Moreno-Coutiño
Paola Berenice Zarate-Segura
Fernando Bastida-González
Erick Martínez-Herrera
Rodolfo Pinto-Almazán
author_sort Ernesto De-La-Rosa-Garibay
collection DOAJ
description Background/Objectives: Endonyx onychomycosis is a chronic infection of the nail plate that presents as milky white discoloration, without hyperkeratosis or onycholysis, and was originally described as being caused by <i>T. soudanense</i> and <i>T. violaceum</i>. Methods: In the present review, the definitions used in the different articles and the clinical characteristics of patients diagnosed with this onychomycosis variant were analyzed through a systematic review of the reported cases in the literature using the terms “endonyx” AND “onychomycosis” in PUBMED, SciELO, SCOPUS, Web of Science, and Google Academics databases. Results: We found 28 articles with a total of 175 patients diagnosed with endonyx onychomycosis, mainly reported in Asia and Africa. Nine papers presented detailed descriptions. From these, a total of 15 immunocompetent patients were registered, and the etiological agents reported were <i>Trichophyton soudanense</i>, <i>T. rubrum</i>, <i>T. violaceum</i>, <i>T. tonsurans</i>, and <i>Fusarium</i> spp. After analyzing the definitions employed in the remaining articles, only 47.3% cited or described a concept consistent with the original description. The other 47.3% of the studies lacked a traceable criterion for the diagnosis of these cases. Moreover, most studies analyzed their data at a global level, describing little information to provide specific insights into the endonyx variant. Conclusions: Emphasis on clinical description and histopathological analysis is essential to confirm the role of less commonly reported fungi, and more accurate diagnostic and treatment protocols for this condition are mandatory.
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spelling doaj-art-93770d97398d4f3aaa2a7f2d576076712025-08-20T02:17:24ZengMDPI AGDiseases2079-97212025-04-0113411010.3390/diseases13040110Onychomycosis Endonyx: A Systematic ReviewErnesto De-La-Rosa-Garibay0Roberto Arenas1Martha Y. Herrera-Castro2Alicia Valdez-Gaona3Gabriela Moreno-Coutiño4Paola Berenice Zarate-Segura5Fernando Bastida-González6Erick Martínez-Herrera7Rodolfo Pinto-Almazán8Mycology Section, Hospital General Dr. Manuel Gea González, Mexico City 14080, MexicoMycology Section, Hospital General Dr. Manuel Gea González, Mexico City 14080, MexicoMycology Section, Hospital General Dr. Manuel Gea González, Mexico City 14080, MexicoMycology Section, Hospital General Dr. Manuel Gea González, Mexico City 14080, MexicoMycology Section, Hospital General Dr. Manuel Gea González, Mexico City 14080, MexicoSección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón, Mexico City 11340, MexicoLaboratorio de Biología Molecular, Laboratorio Estatal de Salud Pública del Estado de México, Mexico City 50130, MexicoSección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón, Mexico City 11340, MexicoSección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón, Mexico City 11340, MexicoBackground/Objectives: Endonyx onychomycosis is a chronic infection of the nail plate that presents as milky white discoloration, without hyperkeratosis or onycholysis, and was originally described as being caused by <i>T. soudanense</i> and <i>T. violaceum</i>. Methods: In the present review, the definitions used in the different articles and the clinical characteristics of patients diagnosed with this onychomycosis variant were analyzed through a systematic review of the reported cases in the literature using the terms “endonyx” AND “onychomycosis” in PUBMED, SciELO, SCOPUS, Web of Science, and Google Academics databases. Results: We found 28 articles with a total of 175 patients diagnosed with endonyx onychomycosis, mainly reported in Asia and Africa. Nine papers presented detailed descriptions. From these, a total of 15 immunocompetent patients were registered, and the etiological agents reported were <i>Trichophyton soudanense</i>, <i>T. rubrum</i>, <i>T. violaceum</i>, <i>T. tonsurans</i>, and <i>Fusarium</i> spp. After analyzing the definitions employed in the remaining articles, only 47.3% cited or described a concept consistent with the original description. The other 47.3% of the studies lacked a traceable criterion for the diagnosis of these cases. Moreover, most studies analyzed their data at a global level, describing little information to provide specific insights into the endonyx variant. Conclusions: Emphasis on clinical description and histopathological analysis is essential to confirm the role of less commonly reported fungi, and more accurate diagnostic and treatment protocols for this condition are mandatory.https://www.mdpi.com/2079-9721/13/4/110onychomycosis classificationendonyx onychomycosis<i>Trichophyton soudanense</i><i>Trichophyton rubrum</i><i>Trichophyton violaceum</i>
spellingShingle Ernesto De-La-Rosa-Garibay
Roberto Arenas
Martha Y. Herrera-Castro
Alicia Valdez-Gaona
Gabriela Moreno-Coutiño
Paola Berenice Zarate-Segura
Fernando Bastida-González
Erick Martínez-Herrera
Rodolfo Pinto-Almazán
Onychomycosis Endonyx: A Systematic Review
Diseases
onychomycosis classification
endonyx onychomycosis
<i>Trichophyton soudanense</i>
<i>Trichophyton rubrum</i>
<i>Trichophyton violaceum</i>
title Onychomycosis Endonyx: A Systematic Review
title_full Onychomycosis Endonyx: A Systematic Review
title_fullStr Onychomycosis Endonyx: A Systematic Review
title_full_unstemmed Onychomycosis Endonyx: A Systematic Review
title_short Onychomycosis Endonyx: A Systematic Review
title_sort onychomycosis endonyx a systematic review
topic onychomycosis classification
endonyx onychomycosis
<i>Trichophyton soudanense</i>
<i>Trichophyton rubrum</i>
<i>Trichophyton violaceum</i>
url https://www.mdpi.com/2079-9721/13/4/110
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