Onychomycosis in Iran: epidemiology, causative agents and clinical features.

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 clinico-mycological 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.