Prevalence of Onychomycosis in Hail Region, Saudi Arabia

Introduction: Dermatophytes, yeast and non-dermatophyte molds causes onychomycosis, which is the fungal infection of the nail bed and skin beneath, have four clinical types: Distal subungual, proximal subungual, superficial and total dystrophic. Aim: Isolation and identification of causative agents by conventional and molecular methods in order to examine the relative prevalence of dermatophytes, yeast and non dermatophyte molds among patients and correlate the clinical pattern to the agents. Materials and Methods: From dermatology private clinics, beauty salons and female students of Hail University, adults(15- 70 years old) crusts and nail clipping particles of 450 nail samples were collected from toe nails and finger nails in sterile petri dishes. Direct microscopic examination was applied with KOH 20% and gentle heating. Culture, API 32 C® and PCR-ITS, PCR-RFLP were carried out. Results: Positive cases for fungal elements were 296 (65.8%), DLSO were the major type (50.6%), TDO (31.5%), PSO (10.5%) and SWO (1.7%). As causative agents Candida albican was 33.1%, Trichophyton rubrum 18.2%, Trichophyton mentagrophytes complex 16.9%, mixed infection 14.5%, Epidermophyton floccosum 9.5% and Aspergillus niger was 7.8%. Conclusion: Dermatophyteic onychomycosis were mostly found followed by yeast and non dermatophyte molds. Accurate identification of the causative agents help managing onychomycosis by giving the correct antifungal treatment, patients awareness prevent relapse and malformation of nails.