Onychomycosis is fungal infection of one or more of the nail units. However, because fungi cause only about half of all nail dystrophies, the use of appropriate diagnostic techniques is important to ensure correct diagnosis and treatment. Aim of the present study was to compare direct microscopy, culture and HPE-PAS for diagnosis of onychomycosis by evaluating their sensitivity and various other relevant statistical parameters. A prospective, hospital-based, cross-sectional study was conducted on 216 patients with a high degree of clinical suspicion of onychomycosis. Nail specimens were evaluated using three diagnostic methods, i.e. direct microscopy using 20% Potassium hydroxide (KOH) & 40% Di-methyl-suphoxide (DMSO), culture and histopathological examination using PAS stain (HPE-PAS). Of 216 patients direct microscopy was positive in 138 (63.9%), culture in 147 (68%) and HPE-PAS in 164 patients (76%). One hundred and seventy-nine patients fitted into the criteria set for confirmed diagnosis of onychomycosis. Using this as a denominator; direct microscopy, culture and HPE-PAS had sensitivities of 77.1%, 70% and 91.6% respectively. Also, HPE-PAS showed the highest sensitivity of 94.7% in 19 cases with prediagnostic antimycotic treatment compared to direct microscopy (42.1%) or culture (57.9%). HPE-PAS shows high sensitivity for diagnosis of onychomycosis and can be considered as a gold standard in the diagnosis of onychomycosis.
Introduction: Genetic diseases of the skin or genodermatoses are a group of inherited disorders with a conglomeration of cutaneous and systemic signs and symptoms. Study aimed to document the pattern, describe the diverse clinical presentations and define the magnitude of various genetic dermatological disorders among the patients from Muslim majority population of north India. Material and Methods: One hundred and twenty eight patients with the clinically proven genetic dermatological disorder reporting to a tertiary care teaching hospital during a period one and a half year from August 2014 to January 2016 were enrolled and epidemiologic and demographic features studied in detail. Results: Among 128 patients, there were 69 males and 59 females with M: F ratio of 1.17:1. Prevalence of genetic disorders was 0.72 per 100 new cases. The most common group of disorder reported was ichthyosiform disorder in 30 patients followed by genetic blistering disorders (epidermolysis bullosa) in 13. Family history of same disorder was seen in 43/128(33.59%). Parental history of consanguinity was observed in 74/128 (57.8%). Conclusions: This study is first of its kind from this part of country to document the pattern of genetic dermatological disorders in Muslim majority population. We found a high rate of parental consanguinity, a high percentage of patients with a positive family history, and many siblings affected by these genetic skin diseases.
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