Childhood white superficial onychomycosis caused by Trichophyton rubrum : Report of seven cases and review of the literature

Abstract Background: Although white superficial onychomycosis (WSO) is well recognized in adults and considered to be mainly caused by Trichophyton mentagrophytes , childhood WSO is rare. WSO caused by Trichophyton rubrum in prepubertal children has never been reported. Objective: Our purpose was to describe the existence of WSO in children and to emphasize that T. rubrum may be its main cause. Methods: Seven children with WSO seen between 1988 and 1993 were examined. Only patients who had a positive potassium hydroxide preparation and a positive fungal culture were included. Results: Seven healthy prepubertal children, 2 to 9 years of age, were identified with WSO. All cases were proved to be caused by T. rubrum . Six patients had associated tinea pedis, and five had a family history of tinea pedis. Topical antifungal therapy was partially effective in some cases. Conclusion: This report documents the existence of WSO in prepubertal children. All cultures grew T. rubrum . Although onychomycosis is not as common in prepubertal children as in adults, it may be underrecognized. (J Am Acad Dermatol 1997;36:29-32.)