Pattern of Onychomycosis among Diabetic and Non-Diabetic Patients at a Tertiary Care Hospital in Bangladesh

Abstract

Any fungal infection affecting the nail apparatus is referred to as onychomycosis. Onychomycosis is a prevalent nail infection worldwide and is more common among patients with diabetes. A variety of fungus species are responsible for onychomycosis. The purpose of this study was to determine the pattern of onychomycosis among patients with and without diabetes at the Department of dermatology and venereology, Bangabandhu Sheikh Mujib Medical University (BSMMU) Hospital, Dhaka, Bangladesh. In this study, a total of 87 clinically diagnosed patients of onychomycosis with diabetic or non-diabetic were included purposively. The infected nail materials were scraped and then processed in Sabouraud's dextrose agar media (SDA) and Dermatophyte test media (DTM) for microscopy and culture. Clinical features, microscopic examination findings and culture interpretations were recorded and compared between the groups. Out of 87 patients of onychomycosis, 54 patients had diabetic and 33 patients were non-diabetic. Growth of fungus was found significantly higher among diabetic patients (85.19% versus 57.58%, p= 0.004). Dermatophytes were more frequent in diabetic patients, but Candida albicans and non-albicans Candida species were more common in non-diabetic patients. Trichophyton rubrum, and Trichophyton mentagrophytes were found in 24 (44.44%) and 19 (35.18%) diabetic patients. On the other hand, Candida albicans 8 (24.24%) and non-albicans candida species 8 (24.24%) were found majority of the non-diabetic patients. Nail discoloration and disfigurement of nails are the common presentation of onychomycosis. Dermatophytes are significantly more frequent among diabetic patients. The clinical presentation of onychomycosis in patients with diabetes differed from that in non-diabetic subjects.