Clinico-mycological study of onychomycosis

Abstract

<p class="abstract"><strong>Background:</strong> Onychomycosis is the most common infective nail disorder accounting for 30% of cutaneous mycoses. Though predominantly caused by dermatophytes, yeast and non-dermatophyte moulds have also been implicated. Aim of this study was to describe and analyse clinical and mycological pattern of onychomycosis.</p><p class="abstract"><strong>Methods:</strong> One hundred patients with onychomycosis diagnosed by direct potassium hydroxide microscopy and culture were included. Nail specimens were collected for fungal culture as per standard procedure. An analysis of demographic data, clinical features and mycological results was made.<strong></strong></p><p class="abstract"><strong>Results:</strong> Majority of the affected cases were between 19 to 85 years of age. Fingernail onychomycosis was seen in 41 patients, toenail was seen in 46 patients, concurrent involvement was seen in 13 patients. The predominant clinical pattern seen was distal lateral subungual type (70%). Culture was positive among 49% patients. Among these patients non dermatophyte growth was predominant (72%) showing. <em>Aspergillus </em>species (31%) and <em>Fusarium </em>species (31%), <em>Cladosporium</em> species (4%) and <em>Scytalidium </em>species (2%). <em>Trichophyton </em>species (16%) and <em>Candida </em>species<em> </em>(16%) were also isolated. The clinico-etiological correlation revealed that a single pathogen could give rise to more than one clinical type of onychomycosis. Non-Dermatophyte moulds were the most common isolate followed by yeasts and dermatophytes. This is in contrast to earlier studies from a similar geographical region where dermatophytes were the commonest pathogen.</p><p class="abstract"><strong>Conclusions:</strong> Non-dermatophyte moulds are emerging as the predominant isolate in onychomycosis. The clinical pattern of nail involvement showed no correlation with the fungal isolate.</p>