Pang Shiu Ming, Pang Jonathan Yi Yu, Fook-Chong Stephanie, Tan Ai Ling
Department of Dermatology, Singapore General Hospital, Singapore.
Transplant Centre, Singapore General Hospital, Singapore.
Singapore Med J. 2018 Oct;59(10):524-527. doi: 10.11622/smedj.2018037. Epub 2018 Mar 19.
Tinea unguium is a common nail infection. We conducted a retrospective ten-year study of the patient demographics and species distribution of dermatophytes causing tinea unguium in a tertiary hospital from Singapore.
Results of fungal nail cultures were retrieved from our hospital's microbiology department. Samples from nail scrapings and clippings were inoculated onto agar plates (Sabouraud dextrose agar with chloramphenicol and Mycosel agar). Nail specimens that grew dermatophytes were included in the study.
Overall, 229 (male: n = 164, 71.6%; female: n = 65, 28.4%) nail specimens grew dermatophytes. Mean patient age was 58 (range 18-93) years. A majority of specimens came from patients aged over 50 years (n = 162, 70.7%) and 60-79 years (n = 100, 43.7%). Ethnically, 160 (69.9%) patients were Chinese, 36 (15.7%) Indian, 18 (7.9%) Malay and 15 (6.6%) of other ethnicities. Among dermatophytes isolated were Trichophyton rubrum (n = 93, 40.6%), Trichophyton mentagrophytes (n = 60, 26.2%), unidentified Trichophyton spp. (n = 57, 24.9%), Trichophyton tonsurans (n = 10, 4.4%), Epidermophyton floccosum (n = 5, 2.2%), Trichophyton verrucosum (n = 2, 0.9%), Trichophyton soudanense (n = 1, 0.4%) and Trichophyton violaceum (n = 1, 0.4%).
A majority of isolates were from elderly patients. Compared to Singapore's general population, patients of Indian and other ethnicities were over-represented for tinea unguium when compared to Chinese and Malay patients. Trichophyton rubrum was the most common dermatophyte isolated, while Trichophyton verrucosum, Trichophyton violaceum and Trichophyton soudanense were rare causes of tinea unguium.
甲癣是一种常见的指甲感染。我们对新加坡一家三级医院中引起甲癣的皮肤癣菌患者人口统计学和菌种分布进行了一项为期十年的回顾性研究。
从我院微生物科获取真菌指甲培养结果。将指甲刮屑和剪下物的样本接种到琼脂平板上（含氯霉素的沙氏葡萄糖琼脂和霉菌琼脂）。培养出皮肤癣菌的指甲标本纳入研究。
总体而言，229份指甲标本培养出皮肤癣菌（男性：n = 164，71.6%；女性：n = 65，28.4%）。患者平均年龄为58岁（范围18 - 93岁）。大多数标本来自50岁以上患者（n = 162，70.7%）以及60 - 79岁患者（n = 100，43.7%）。按种族划分，160名（69.9%）患者为华裔，36名（15.7%）为印度裔，18名（7.9%）为马来裔，15名（6.6%）为其他种族。分离出的皮肤癣菌包括红色毛癣菌（n = 93，40.6%）、须癣毛癣菌（n = 60，26.2%）、未鉴定的毛癣菌属菌种（n = 57，24.9%）、断发毛癣菌（n = 10，4.4%）、絮状表皮癣菌（n = 5，2.2%）、疣状毛癣菌（n = 2，0.9%）、苏丹毛癣菌（n = 1，0.4%）和紫色毛癣菌（n = 1，0.4%）。
大多数分离菌株来自老年患者。与新加坡普通人群相比，印度裔和其他种族患者中甲癣的比例高于华裔和马来裔患者。红色毛癣菌是分离出的最常见皮肤癣菌，而疣状毛癣菌、紫色毛癣菌和苏丹毛癣菌是甲癣的罕见病因。
