Onychomycosis in Iran: Epidemiology, Causative Agents and Clinical Features

Abstract

Background: Onychomycosis represents the most frequently encountered nail disease, which is difficult to eradicate with drug treatment. Aim: This study was undertaken to document the clinicomycological pattern of onychomycosis in Iran. Results of mycological tests of nail scrapings collected over a 4-year period were analyzed. Methods: Both direct microscopy and cultures of the nail material were performed to identify the causative agents. Results: The microscopic and/or cultural detection of fungi was positive in 40.2% of samples. The most common clinical type noted was distolateral subungual onychomycosis in 48.4% of cases. Etiological fungal agents were 50% dermatophytes, 46.8% yeasts, and 3.2% saprophytic moulds. The most frequently detected dermatophyte species were Trichophyton rubrum(48.4%)and T. mentagrophytes(41.9%) . Among yeasts, Candida albicans(58.6)was most common, followed by C. parapsilosis(17.2%) , C. glabrata(10.3%) , C. krusei and C. tropicalis(each 6.9%) . Aspergillus niger and A. flavus were the most frequent saprophytic moulds. Females were affected more frequently than males, and in both sexes those most infected were between 40-49 years of age. Fingernails were affected more frequently than toenails. Conclusions: The clinico-epidemiological data collected can serve as reference for future research and may be useful in the development of preventive and educational strategies.

Non dermatophytic molds causing onychomycosis: a rising trend in North India

“…In studies which were conducted by Lone et al in Kashmir, Aghamirian et al in Iran, Kaur et al in New Delhi, Das et al in Kolkata and Jesudanam et al in Vishakhapatnam, 60%, 40.2%, 54.5%, 51.76% and 45.53% samples respectively were found to be positive by direct examination and/or culture. 9,14,[16][17][18] In our study, culture positivity (79%) was more than microscopy (63%), similar to another study conducted by Das et al in 2008 in Kolkata, where 32.9% were positive by direct microscopy and 49.4% by culture. While, studies conducted by Lone et al in 2013 and Shenoy et al in 2008 found more positivity by direct microscopy than culture, with a positive result by microscopy in 56% and 53% and culture positivity in 40% and 35% respectively.…”

“…3 Similar findings with frequent involvement of finger nails were also seen in studies conducted by Lone et al in Kashmir, Sarma et al in new Delhi and Aghamirian et al in Iran. 9,10,14 The lower incidence of toe nail onychomycosis could be because of lesser cosmetic awareness on their disfigurement, and less of occupation related trauma compared to finger nails.…”

Clinico-Mycological Pattern of Onychomycosis: A single center one year study in Kashmir-North India

“…The increased prevalence of in young age could be because of occupation related trauma and cosmetic awareness. In our study distolateral subungal onychomycosis was the commonest clinical pattern in 66% cases followed by proximal subungal onychomycosis (16%) as was found in other studies (12,13). The present study showed finger nails were involved more often than toe nails.…”

Fungal agents in different anatomical sites in Public Health Services in Cuiabá, state of Mato Grosso, Brazil

“…Onychomycosis of fingernails is most 8 prevalent in females while toenail infection is common in male patients 1,57 . Candida species is the dominant cause of onychomycosis in women and dermatophytes is the principal cause of this condition in men 35,51 .…”