Clinicomycological Study of Onychomycosis in Dermatology Patients Attending a Tertiary Care Hospital
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Abstract
Background: Onychomycosis is a chronic fungal infection involving the nail plate, nail bed, and periungual tissues. It represents the most common nail disorder, accounting for nearly 50% of all nail diseases. Although it is not life-threatening, onychomycosis causes significant morbidity due to pain, discomfort, functional impairment, and cosmetic disfigurement. Additionally, affected nails may act as a reservoir for fungal infections, particularly in immunocompromised individuals, thereby necessitating early diagnosis and appropriate management.
Aim: To study and evaluate the clinico-mycological pattern of onychomycosis among patients attending a tertiary care hospital in Navi Mumbai.
Methods: A total of 118 nail specimens were collected from patients clinically suspected of having onychomycosis. Severely affected nail clippings were subjected to direct microscopic examination using potassium hydroxide (KOH) mounts. Fungal culture was performed on Sabouraud’s dextrose agar and Dermatophyte Test Medium to facilitate isolation and identification of the causative organisms.
Results: Out of 118 nail specimens cultured, fungal growth was obtained in 50 cases. The highest prevalence of onychomycosis was observed in patients aged 46–55 years. Males were more commonly affected than females. Distal and lateral subungual onychomycosis was the most frequent clinical presentation, accounting for 42% of cases. Diabetes mellitus and hypertension were the most commonly associated co-morbidities. Dermatophytes constituted the predominant etiological agents (58%), followed by non-dermatophyte molds (24%). The most frequently isolated organisms were Trichophyton rubrum, Trichophyton mentagrophytes, Candida albicans, and Aspergillus niger.
Limitations: Treatment and long-term follow-up of patients could not be undertaken due to time constraints.
Conclusion: Accurate identification of the etiological agents of onychomycosis is crucial for effective treatment, prevention of recurrence, and improvement in patient quality of life. Early diagnosis enables timely intervention, promotes nail recovery, and minimizes complications.