A study of onychomycosis in patients attending a dermatology center in Tehran, Iran.

OBJECTIVE: To determine the incidence of onychomycosis based on age and sex, morphological pattern of the disease, predisposing factors and identification of fungus by direct microscopy and culture methods.

METHODS: A prospective study was conducted on 140 patients with nail disorders. A detailed history and thorough examination was done in all patients. The samples were taken from patients clinically suspected of fingernails and toenails infections attending a dermatology center in Tehran, Iran. The nails were subjected to potassium hydroxide (KOH) examination and fungal culture on Sabouraud's dextrose agar (SDA) medium.

RESULTS: Specimens from 79 patients (56.4%) were positive for onychomycosis. The mycological observations showing positive fining with KOH were observed in 79 (56.4%) and culture positive in 35 (25%) cases. Females were more infected than males. The most common age group infected was 41-60 years (40.7%). Toenails were affected more frequently than fingernails and dystrophic onychomycosis was the most common clinical type seen in 39.2% patients. From the culture-positive samples, yeasts were the most common pathogens isolated from 25 (71.4%) patients, followed by non-dermatophytic moulds in 6 (17.1%) and dermatophytes in 4 (11.5%) patients.

CONCLUSION: This study demonstrated that Candida species were the main agents causing onychomycosis in our region and accurate diagnosis of onychomycosis was based on direct microscopy and fungal culture.