摘要
Background. Onychomycosis is mainly caused by dermatophytes, but yeasts and nondermatophyte molds have also been implicated, giving rise to diverse clinical presentations. The etiological agents of the disease may show geographic variation. The aim of the present study was to isolate the causative pathogens and to determine the various clinical patterns of onychomycosis in central India. Methods. The study population comprised 90 patients with onychomycosis. Nail samples were collected for direct microscopic examination and culture. Clinical patternswere noted and correlatedwith causative pathogens. Results. The male: female ratio was 3:1 and the mean age was 29.40 ±13.61 years. Fingernails were involved in 60%, toenails in 26.67%and both fingernails and toenails in 13.34%of the 90 patients. The clinical types noted were distolateral subungual onychomycosis (64.44%), total dystrophic onychomycosis (17.78%), proximal subungual onychomycosis with paronychia (12.2%), proximal subungual onychomycosiswith-out paronychia (4.44%) and superficial white onychomycosis (1.11%). Dermatophyteswere themost common pathogens isolated, being found in 24 patients (26.36%) [Tricophyton rubrum (23.07%), Tricophyton verrucosum(2.22%) and Epidermophyton floccosum (1.11%)], followed by Candida albicans, which was found in 22 patients (24.27%). Thirty-six (39.58%) nondermatophyte molds were isolaled from 29 patients. Of these 29 cases, six were associated with Tricophyton rubrum, which was considered the primary pathogen. Conclusions. Distolateral subungual onychomycosis was the most common clinical presentation; however, total dystrophic onychomycosis and proximal subungual onychomycosiswere not uncommonin this part of India. Tricophyton rubrum and Candida albicans were the major pathogens. The clinicoetiologic correlation revealed that a single pathogen could give rise to more than one clinical type. 2004 The International Society of Dermatology.
Background. Onychomycosis is mainly caused by dermatophytes, but yeasts and nondermatophyte molds have also been implicated, giving rise to diverse clinical presentations. The etiological agents of the disease may show geographic variation. The aim of the present study was to isolate the causative pathogens and to determine the various clinical patterns of onychomycosis in central India. Methods. The study population comprised 90 patients with onychomycosis. Nail samples were collected for direct microscopic examination and culture. Clinical patternswere noted and correlatedwith causative pathogens. Results. The male: female ratio was 3:1 and the mean age was 29.40 ±13.61 years. Fingernails were involved in 60%, toenails in 26.67%and both fingernails and toenails in 13.34%of the 90 patients. The clinical types noted were distolateral subungual onychomycosis (64.44%), total dystrophic onychomycosis (17.78%), proximal subungual onychomycosis with paronychia (12.2%), proximal subungual onychomycosiswith-out paronychia (4.44%) and superficial white onychomycosis (1.11%). Dermatophyteswere themost common pathogens isolated, being found in 24 patients (26.36%) [Tricophyton rubrum (23.07%), Tricophyton verrucosum(2.22%) and Epidermophyton floccosum (1.11%)], followed by Candida albicans, which was found in 22 patients (24.27%). Thirty-six (39.58%) nondermatophyte molds were isolaled from 29 patients. Of these 29 cases, six were associated with Tricophyton rubrum, which was considered the primary pathogen. Conclusions. Distolateral subungual onychomycosis was the most common clinical presentation; however, total dystrophic onychomycosis and proximal subungual onychomycosiswere not uncommonin this part of India. Tricophyton rubrum and Candida albicans were the major pathogens. The clinicoetiologic correlation revealed that a single pathogen could give rise to more than one clinical type. 2004 The International Society of Dermatology.
