Shahzad Muhammad, Alzolibani Abdullateef A, Robaee Ahmad A Al, Bin Saif Ghada A, Babikir Ibrahim H K, Abdel-Magied Eltuhami M, Elsayed Abeer E
Assistant Professor, Department of Dermatology, College of Medicine, Qassim University , Saudi Arabia .
Associate Professor, Department of Dermatology, College of Medicine, Qassim University , Saudi Arabia .
J Clin Diagn Res. 2014 Aug;8(8):YC01-4. doi: 10.7860/JCDR/2014/8277.4757. Epub 2014 Aug 20.
Onychomycosis is mainly caused by dermatophytes, but yeasts and nondermatophyte molds have also been implicated, giving rise to diverse clinical presentations. The aetiological agents of the disease may show geographic variation.
The aim of the present study was to isolate the causative pathogens and to correlate the various clinical patterns of onychomycosis with causative pathogens.
The study population comprised 170 patients with clinical suspicion of onychomycosis. Nail samples were collected for direct microscopic examination and culture. Clinical patterns were noted and correlated with causative pathogens.
Out of total 170 cases included in the study, 140 (82.4%) were positive by microscopy and 77 (45.3%) showed positive mycological findings by both microscopy and culture. The male: female ratio was 1:2.5 and the mean age was 35.29 ± 16.47 years. Fingernails were involved in 51.9%, toenails in 28.6% and both fingernails and toenails in 19.5% of the 77 patients. The clinical types noted were distal lateral subungual onychomycosis (71.4%), proximal subungual onychomycosis (10.4%), total dystrophic onychomycosis (10.4%), superficial white onychomycosis (3.9%) and mixed pattern onychomycosis (3.9%). Yeasts were the most common pathogens isolated, being found in 36 patients (46.8%) followed by nondermatophyte molds which were isolated from 28 patients (36.4%) followed by dermatophytes which were isolated from 13 patients (16.9%).
Distal lateral subungual onychomycosis was the most common clinical presentation. Candida albicans, Aspergillus species and Tricophyton rubrum were the major pathogens. A single pathogen can give rise to more than one clinical type.
甲癣主要由皮肤癣菌引起，但酵母菌和非皮肤癣菌性霉菌也与之有关，导致了多样的临床表现。该疾病的病原体可能存在地域差异。
本研究的目的是分离致病病原体，并将甲癣的各种临床类型与致病病原体相关联。
研究对象包括170例临床怀疑患有甲癣的患者。采集指甲样本进行直接显微镜检查和培养。记录临床类型并与致病病原体相关联。
在纳入研究的170例病例中，140例（82.4%）显微镜检查呈阳性，77例（45.3%）显微镜检查和培养均显示真菌学阳性结果。男女比例为1:2.5，平均年龄为35.29±16.47岁。在77例患者中，51.9%累及手指甲，28.6%累及脚趾甲，19.5%手指甲和脚趾甲均受累。记录的临床类型有远端侧位甲下甲癣（71.4%）、近端甲下甲癣（10.4%）、全甲营养不良性甲癣（10.4%）、浅表白色甲癣（3.9%）和混合型甲癣（3.9%）。分离出的最常见病原体是酵母菌，在36例患者（46.8%）中发现，其次是非皮肤癣菌性霉菌，从28例患者（36.4%）中分离出，然后是皮肤癣菌，从13例患者（16.9%）中分离出。
远端侧位甲下甲癣是最常见的临床表现。白色念珠菌、曲霉菌属和红色毛癣菌是主要病原体。单一病原体可导致不止一种临床类型。
