A study on clinico-mycological profile, aetiological agents and diagnosis of onychomycosis at a government medical college hospital in kashmir

Abstract

Background: Onychomycosis is a major public health problem with a high incidence, associated morbidity and a long lasting treatment with anti-fungal agents. This study was carried out to know the clinico-mycological pattern of onychomycosis, which could help in the control of this infection.

Aims: The aim of this study was to determine the prevalence of various causative agents of onychomycosis and to study the clinical and mycological patterns of onychomycosis.

Material and methods: This was a prospective study which was carried over a period of one year, from 1(st) February 2011 to 31(st) January 2012 on samples from 150 patients with clinically suspected nail infections, who attended the Dermatology Department of SKIMS Medical college, Kashmir, India. The nails were evaluated clinically and the nail samples were subjected to direct microscopy and culture.

Results: 60% samples were found to be positive by direct microscopy and culture. Males were infected more than females. The commonest age group which was infected was the 21-30 years age group. Finger nails were affected more frequently than toe nails and distolateral subungal onychomycosis was the most common clinical type of infection which was seen in 64.44% patients. The aetiological agents were dermatophytes (61.66%), Non-Dermatophyte Moulds (NDM) (31.66%) and yeasts (6.66%). Among dermatophytes, T. rubrum was the commonest aetiological agent.

Conclusion: Although dermatophytes were the main causative agents, NDM and yeasts were also not uncommon aetiological agents of onychomycosis. This study also emphasized the need of performing both a direct examination and culture to improve sensitivity. Since onychomycosis can cause physical, psycological and occupational problems, the clinico-epidemiological data can be helpful in development of preventive and diagnostic strategies.

Keywords: Onychomycosis; dermatophytes; non-dermatophyte moulds; yeasts.