Mycological Study of Onychomycosis in Erbil City

Abstract

Background: Onychomycosis is a common problem seen in dermatology practice. Given the differential diagnosis of dystrophic nails, it is helpful to know an exact diagnosis of dermatophyte infection before starting antifungal therapy. The disease can have inevitable negative consequences for patients, such as pain, swelling and can potentially undermine work and social lives.

Aims: The study aimed to demonstrate the prevalence of onychomycosis etiological agents and study the clinico-mycological patterns of onychomycosis.

Methods: This prospective study carried over six months on a sample of 106 patients with clinically suspected nail infections who attended the Erbil Dermatology Teaching Center in Erbil City, Kurdistan Region-Iraq. The nails were evaluated clinically, and the samples were subjected to culture. The growth in cultures were examined morphologically, microscopically and biochemical reactivity.

Results: The most common clinical patterns of onychomycosis were total dystrophic onychomycosis (22.6% of fingernails and 31.1% of toenails) and distolateral subungual onychomycosis (23.6% of fingernails and 23.6% of toenails). Out of 106 cases, their mycological culture showed positive results in 96 (89.6%) and no growth cultures were 10 (9.4%) cases. In total dystrophic type Candida spp were most ftrequent type of fungi in both finger nail (79.2%) and toenails (93.9%). In ditolateral type Trichophyton spp were the most common isolated fungi which constituted 48% in fingernails and 64% in toenails.

Conclusion: Onychomycosis were more common in 30-40 years old age group. The most frequent agent identified in cultures of onychomycosis was Candida Albicans (44.3%). Mold was found in only one case (0.9%) represented by Fusarium oxysporum. There was a significant association between the clinical pattern of onychomycosis and culture results (p<0.001).