Onycomychosis due to Scytalidium spp.: a clinical and epidemiologic study at a University Hospital in Rio de Janeiro, Brazil

Abstract

Background: Scytalidium sp. is a filamentous (thread-like), saprobic fungus which affects soil and plants. It is currently considered a primary pathogen of the nail. The prevalence of nail infections caused by this fungus has been increasing in recent decades, although few published studies have been done on its epidemiology.

Objective: To study clinico-epidemiological data referring to patients with onychomycosis caused by Scytalidium spp. at a University Hospital in Rio de Janeiro.

Methods: We evaluated the clinical and epidemiological data of 30 patients with onychomycosis by Scytalidium sp. through an observational study of 1295 patients who underwent mycological nail tests over a period of 16 months.

Results: The majority of the patients were female (66.6%), with an average age of 56.7 years. 63.3% of them were nonwhite. 53.3% of the patients had attended elementary school and 36.6% referred a family income of 3 to 5 minimum wages. In 90% of cases, the toenails were affected, primarily with onycholysis (18 patients), and in 66% of the cases melanonychia was observed. In 43.3% of cases the disease had progressed for more than 5 years. 19 patients (63.3%) had undergone some medical treatment for their current condition.

Conclusions: Our data show that nail infection by Scytalidium sp. is chronic, affecting adults, particularly females (2:1). Clinically the disease resembles dermatophytosis. Prevalence of the disease in our sample was 4.86%, accounting for 26.92% of the positive tests.