Onychomycosis: Multicentre epidemiological, clinical and mycological study

Background: Onychomycosis accounts for up to 50% of all nail disorders. They can be caused by: yeasts, dermatophytes and non-dermatophyte moulds. Objectives and methods: A multicentre study designed to determine the prevalence, mycological test results, aetiological agents, and clinical presentation of onychomycosis was carried out. All fingernail and toenail samples taken during a one year period at 9 diagnostic centres were included. Results: A total of 5,961 samples were analysed, of which 82.3% were from toenails and 17.7% from fingernails. The mean age of the patients was 49.7 years, and 66% were females. Direct microscopic examination was positive in 61% of the samples. In adults, 61.2% of toenails were positive using potassium hydroxide (KOH), and 43.7% were positive in cultures. The prevailing aetiological agents belong to the dermatophyte group (82.8%), and distal subungual was the most common clinical form. In fingernails, direct examination showed 59.8% positive samples, and cultures were positive in 52.9%. The prevailing agents were yeasts belonging to Candida species, and onycholysis was the most common lesion. Conclusions: Direct mycological examinations were positive in 61%, a higher value than that found in other series. Dermatophytes were prevalent in toenails of both sexes, and in finger nails yeast were prevalent in females, and dermatophytes in males. Non-dermatophyte moulds corresponded to 4.8% of toenail and 2.05% of fingernails isolates.Original Abstract: Antecedentes: Las onicomicosis representan aproximadamente el 50% de las onicopatias, pueden ser causadas por dermatofitos. levaduras u hongos filamentosos no dermatofitos. Objetivos y metodologia: Se realizo un estudio multicentrico para conocer la prevalencia de onicomicosis, los agentes causales y las formas clinicas mas frecuentes. Se evaluaron todas las muestras de unas de manos y pies durante el periodo de un ano en 9 centros asistenciales. Resultados: Se procesaron 5.961 muestras, el 82,3% correspondieron a unas de pies y el 17,7% a unas de manos. La edad promedio de los pacientes fue 49,7 anos y el 66% pertenecid al sexo femenino. Los examenes directos fueron positivos en el 61% de los casos. En adultos, las unas de los pies presentaron un 61,2% de resultados positivos en el examen directo, y los cultivos fueron positivos en un 43,7%. Los hongos predominances fueron ios dermatofitos (82,8%) y la forma ciinica mas frecuente fue la distal subungueal. En unas de manos la positi