Sathya Anandam; Anuradha K
Abstract
Background: Onychomycosis is a widespread problem in the clinical practice of dermatology, caused by dermatophytes, yeasts, and non-dermatophyte molds. In India, relatively little work has been done on this problem. It is a known fact that the geographical distribution of the fungi may change from time ...
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Background: Onychomycosis is a widespread problem in the clinical practice of dermatology, caused by dermatophytes, yeasts, and non-dermatophyte molds. In India, relatively little work has been done on this problem. It is a known fact that the geographical distribution of the fungi may change from time to time. Hence, through this study, an attempt was made to identify the clinical patterns and causative agents of onychomycosis. Methods: This study was conducted on 100 clinically suspected onychomycosis patients. The necessary clinical details were noted with their consent. Nail clippings were collected from the most severely affected parts and were subjected to direct microscopy in 40% potassium hydroxide before being inoculated into Sabouraud’s dextrose agar with and without cycloheximide at 25 °C and 37 °C for up to four weeks. Growth was identified following the standard protocols by assessing the rate of growth, colony character, lactophenol cotton blue mount, slide culture, urease test, germ tube test, etc. Results: Among the 100 patients, the mean age was 40.8 years. The male/female ratio was 1.28:1. Fingernail (49%) involvement was more common than toenail involvement (32%). Distal lateral subungual onychomycosis (52%) comprised the predominant clinical pattern. KOH mount was positive in 46%, while the culture was positive in 44% of patients. The causative agents isolated were non-dermatophyte molds (63.6%), dermatophytes (18.2%), and yeasts (18.2%). Conclusion: This work shows the broad spectrum of causative agents of onychomycosis with non-dermatophyte molds as the predominant isolates.
Tafti Hossein Sadeghi; Ahmadikia Kazem; Rashidian Sara; Hekmatimoghaddam Seyed Hossein; Yazdi Zeinab Ayubi
Volume 20, Issue 2 , 2017, , Pages 37-42
Abstract
Background: Onychomycosis, the fungal infection of the toenails or fingernails, is caused by three major groups of fungi including dermatophytes, yeasts and non-dermatophyte molds. The objective of the present study was to determine the incidence of onychomycosis and to identify the causative fungi during ...
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Background: Onychomycosis, the fungal infection of the toenails or fingernails, is caused by three major groups of fungi including dermatophytes, yeasts and non-dermatophyte molds. The objective of the present study was to determine the incidence of onychomycosis and to identify the causative fungi during a one year period in Yazd, Iran. Materials and Methods: From Apr 2013 to Apr 2014 a total of 273 patients with suspected dermatophytosis were included in this study. Nail-clipping specimens of 71 clinically diagnosed cases of onychomycosis were obtained for mycological examination (KOH preparation and fungal culture). Identification of mycelial isolates was based on morphological appearance and microscopic characteristic of the colony. Supplementary methods for identification of dermatophytes were employed. The species of yeasts were identified by germ-tube and chlamydospore test, as well as colony color on chromogenic CHROMagar Candida medium, and the assimilation profile in API 20C Aux system. Results: Of the 71 patients affected by nail disorders, 26 (36.6%) patients of onychomycosis including 54.9% male and 45.1% female (20 fingernails, 6 toenails) via direct examination and/or culture methods were diagnosed. saprophytic fungi were the most prevailing causative agents of onychomycosis and account for up to 69.2%(n=18) of cases, yeasts and dermatophytes were identified as causative agents of onychomycosis in 7 (26.9%) patients and 1 patient (3.8%), respectively. Distribution of fungal isolates was as follows: Aspergillus niger (26.9%), A. fumigatus (19.2%), Candida albicans (15.3%), A. flavus (11.5%), C. tropicalis (7.6%), Penicillium sp. (7.6%), C. dubliniensis (3.8%), Trichophyton mentagrophytes (3.8%) and Fusarium sp. (3.8%). Conclusion: Because of considerable prevalence of onychomycosis, necessity for a careful mycological examination in patients with nail disorders is highlighted.
Jeelani Shazia; Lanker Audil; Jeelani Nasir; Masood Qazi; Fazili Tawheeda; Majid Huma
Volume 19, Issue 3 , 2016, , Pages 79-85
Abstract
Background: Onychomycosis (OM) is the infection of nails caused by a variety of fungi. As systemic antifungal treatment is necessary in the majority of patients, appropriate diagnostic techniques are important to ensure a correct diagnosis and treatment. Objective: This study was carried out to evaluate ...
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Background: Onychomycosis (OM) is the infection of nails caused by a variety of fungi. As systemic antifungal treatment is necessary in the majority of patients, appropriate diagnostic techniques are important to ensure a correct diagnosis and treatment. Objective: This study was carried out to evaluate the clinical, mycological, and histological aspects of onychomycosis in detail. Methods: A cross-sectional study was carried out on 216 patients with a high degree of clinical suspicion for OM. Clinical details including the site, morphological type, and associated diseases were noted in each case. The specimens obtained were subjected to three diagnostic tests: direct microscopy, fungal culture, and histopathological examination using PAS staining. Results: OM was more common in young adults in the age group 20-40 years (40.2%). In the majority (46.3%) of the cases, the duration of the disease was ≤ 1year. Distal and lateral subungual onychomycosis was the most common (73.6%) clinical type. A high incidence of toe nail onychomycosis (68.5%) was noted in our study. Dermatophytes were the most common etiological agent. Among the dermatophytes, Trichophyton mentagrophytes was the most common isolated fungus. Histopathological examination using PAS staining (HPE-PAS) showed the highest sensitivity of 91.6% among the three tests. Conclusion: Dermatophytes are the main agents responsible for OM in this region with T. mentagrophytes being the most common isolate. This study also demonstrated the importance of performing routine histopathology in addition to direct examination and culture for the diagnosis of onychomycosis.
M Karimzadegan Nia; A Miramin Mohamadi; AR Firooz; MR Shidfar
Volume 7, Issue 2 , 2004, , Pages 95-100
Abstract
Background: At present time, the diagnosis of onychomycosis is based on clinical signs, direct exam and fungal culture, whereas Pathologic methods have shown to be more sensitive than other methods. Objective: Evaluation of pathologic methods in the diagnosis of onychomycosis in comparison to direct ...
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Background: At present time, the diagnosis of onychomycosis is based on clinical signs, direct exam and fungal culture, whereas Pathologic methods have shown to be more sensitive than other methods. Objective: Evaluation of pathologic methods in the diagnosis of onychomycosis in comparison to direct smear and culture. Patients and Methods: A nail sample was cut form 96 suspected onychomycosis patients by nail clipper. Then it was divided to four pats, and one part was stored. One part was fixed in 4% formalin and examined pathologically (PATH-PAS method). Another part was cultured in mycosil agar and Sabour and Dextrose Agar media and kept in room temperature for 4 weeks. Another part was directly examined by 10% KOH. The results of each method were recorded separately without knowing the results of others. Clinical signs with at least one positive result were considered as onychomycosis and the sensitivity of these methods were compared. Results: The most sensitive method was the combination of PATH-PAS and direct smear (98%). There was no significant difference between the sensitivity of smear and pathological method, where as PATH-PAS and culture differed significantly. Conclusion: PATH-PAS is a simple and very sensitive method in the diagnosis of onychomycosis.