A One Year Cross-Sectional Clinico-Mycological Study Of Onychomycosis In Kles Dr Prabhakar Kore Hospital And Medical Research Centre, Belgaum

Abstract

Background: Onychomycosis is no longer considered as a simple cosmetic problem, but it is an important and significant disease, which can generate many occupational, physical and psychological problems impairing patient’s quality of life. Objectives: To study the clinical types, etiological agents, sex distribution, age, occupation, duration of infection, aggravating factors, associated fungal infections causing onychomycosis and to compare KOH and culture in diagnosis Methodology: The present one year cross-sectional study was done in KLES, Dr Prabhakar Kore Hospital and MRC, Belagavi from January 2015 to December 2015. A total of 50 patients presenting with clinical features of onychomycosis were subjected to KOH examination and culture for fungi. Results Commonest age group was 51-60 years (22%) with male preponderance (52%). The maximum number of patients were housewives (34%) and most of them presented with in 1 year (56%). Hyperhidrosis and warmth were common aggravating factors. Discolouration (62%) of nails was the most common presenting complaint. Subungual hypertrophy (80%) and onycholysis (40%) were the most common clinical changes observed. Toe nails (44%) were most commonly involved. DLSO (66%) was the most common morphological pattern observed. Tinea corporis (6%) and diabetes mellitus (8%) were the most common associated conditions. Isolation rate of fungus was 92% (46 out of 50). The higher incidence of culture positivity (92%) than KOH positivity (50%) was observed. Out of 46 culture positive specimens, the maximum were NDM (63%). The most common NDM isolated was Aspergillus niger (13). The most common dermatophyte isolated was Trichophyton mentagrophyte (8). Yeasts like Candida kruzei (C.kru), Candida tropicalis (C.trop), Candida lusitanea (C.lusi) were isolated. DLSO, PSO and TDO were most commonly caused by NDM. Conclusion The present study highlights the necessity of microbiological confirmation in case of onychomycosis and also stresses that diagnosis of onychomycosis solely based on clinical features is often misleading. Culture was considered the gold standard for the diagnosis of onychomycosis. It is cheaper and routinely available test