Agarwalla Arun, Agrawal Sudha, Khanal Basudha
Department of Dermatology, Marwari Maternity Hospital, Adhgaon, Guwahati, Assam, India.
Nepal Med Coll J. 2006 Dec;8(4):215-9.
Onychomycosis, a fungal infection of the nail is responsible for up to 50.0% of all nail diseases. Though, dermatophytes are most frequently implicated as the causative agents in onychomycosis, yeast and molds are increasingly recognized as causative pathogens. This study was aimed to know the clinical and mycological pattern of onychomycosis in eastern Nepal. Eighty-two clinically diagnosed patients of onychomycosis attending the Dermatology Outpatient department of a tertiary hospital over a period of one year were enrolled in this study. Clipping from the severely affected nail and skin scrapping from active border of the skin lesions if associated were collected from each patient and subjected to microscopy and culture for identification of fungi. The commonest affected age group was 21-40 years. The male: female ratio was 2.7:1. Fifty-one patients had isolated fingernail involvement, while involvement of toenails was seen in 15 patients. Distolateral subungual onychomycosis (67%) was the commonest clinical type followed in decreasing order by superficial white onychomycosis (14.6%), proximal subungual onychomycosis (9.8%), candidal onychomycosis (7.4%) and total dystrophic onychomycosis (1.2%). Trichophyton mentagrophytes (28.8%) was the most common pathogen isolated followed by Trichophyton rubrum (21.2%), Trichophyton tonsurans (11.5%), Candida albicans (11.5%), Trichospron beigelii, (9.6%), Epidermophyton floccosum (7.7%), Trichophyton violaceum (5.8%), and Aspergillus flavus (3.9%). Distolateral subungual onychomycosis was the most common clinical presentation and T. mentagrophytes and T. rubruni were the most frequently isolated fungi for onychomycosis in eastern Nepal.
甲癣，一种指甲真菌感染，占所有指甲疾病的比例高达50.0%。虽然皮肤癣菌是甲癣最常见的致病因素，但酵母菌和霉菌越来越被认为是致病病原体。本研究旨在了解尼泊尔东部甲癣的临床和真菌学模式。本研究纳入了一家三级医院皮肤科门诊在一年内接诊的82例临床诊断为甲癣的患者。从每位患者严重受累的指甲上剪下指甲，并在有相关皮肤病变时从皮肤病变的活动边缘刮取皮肤，进行显微镜检查和培养以鉴定真菌。最常见的受累年龄组为21 - 40岁。男女比例为2.7:1。51例患者仅累及手指甲，15例患者累及脚趾甲。远端侧位甲下型甲癣（67%）是最常见的临床类型，其次依次为浅表白色甲癣（14.6%）、近端甲下型甲癣（9.8%）、念珠菌性甲癣（7.4%）和全甲营养不良型甲癣（1.2%）。分离出的最常见病原体是须癣毛癣菌（28.8%），其次是红色毛癣菌（21.2%）、断发毛癣菌（11.5%）、白色念珠菌（11.5%）、白吉利丝孢酵母（9.6%）、絮状表皮癣菌（7.7%）、紫色毛癣菌（5.8%）和黄曲霉（3.9%）。远端侧位甲下型甲癣是最常见的临床表现，须癣毛癣菌和红色毛癣菌是尼泊尔东部甲癣最常分离出的真菌。
