摘要
Background: Onychomycosis refers to fungal infection of the nails either as a primary event or secondary infection of a previously diseased or traumatized nail. Some of the risk factors associated with onychomycosis include advancing age; smoking; peripheral arterial disease; diabetes mellitus (DM) and immunosuppression.
Aim: The work aims to determine the clinical characteristics; predisposing factors, causative organisms in patients with onychomycosis who attended the dermatology clinic in Lagos University Teaching Hospital between July 2013 and Jan 2014.
Methods and Materials: This is a prospective observational study. All consenting patients with clinical features suggestive of superficial fungal infections were recruited. Data was collected using a structured questionnaire that contains bio- and socioeconomic data, clinical diagnosis, underlying disease condition and possible predisposing factors. Nail clippings and skin scrapings were taken for KOH microscopy and culture which were by standard methods.
Result: Onychomycosis was found in 19.0% of the patients recruited. The infection was most common between the ages of 30 and 39 (21.9%). Finger nail infections were more common affecting 16(61.5%) patients than toenails 6 (23.1%); and combined toe and fingernail infections were found in 4(15.4%). Dermatophytes accounted for 73.1% (19) of the isolates. The yeast Candida albicans (17.5%) and the dermatophyte Trichophyton rubrum (17.5%) were shown to be the most common pathogens of onychomycosis. Onychomycosis was more common in patients with HIV infection (25.0%).
Conclusion: Onychomycosis was most commonly seen in the adults in this study as opposed to the elderly in other climes and T. rubrum and C albicans were the most commonly cultured organisms.
Keywords: Onychomycosis, fungal infections, risk factors, trichophyton rubrum, candida albicans
Résumé
Contexte : L’onychomycose réfère à une infection fongique des ongles soit comme un événement primaire, ou comme une infection secondaire d’un ongle préalablement malade ou traumatisé. Certains des facteurs de risque associés à l’onychomycose comprennent l’âge avancé; le tabagisme; la maladie artérielle périphérique; le diabète sucré (DM) et l’immunosuppression.
But: Le travail vise à déterminer les caractéristiques cliniques; facteurs prédisposant, organismes causatifs chez les patients atteints d’onychomycose qui ont accédé à la clinique de dermatologie de l’Hôpital d’Enseignement Universitaire de Lagos entre Juillet 2013 et Janvier 2014.
Méthodes et matériaux : Ceci est une étude observationnelle prospective. Tous les patients consentants présentant des signes cliniques suggestifs d’infections fongiques superficielles ont été recrutés. Les données ont été recueillies à l’aide d’un questionnaire structuré qui contient des données bio- et socio-économiques, un diagnostic clinique, l’état pathologique sous étendu et d’éventuels facteurs prédisposant. Des coupures d’ongles et des raclures cutanées ont été prises pour la microscopie et la culture au KOH qui étaient par des méthodes standard.
Résultat: L’onychomycose a été retrouvée chez 19,0% des patients recrutés. L’infection était plus fréquente entre 30 et 39 ans (21,9%). Les infections des ongles des doigts étaient plus fréquentes touchant 16 (61,5%) patients que les ongles des orteils 6 (23,1%); et une infection combinée de l’orteil et de l’ongle ont été trouvées chez 4 (15,4%). Les dermatophytesreprésentaient 73,1% (19) des isolats.La levure Candidaalbicans(17,5%)et ledermatophyteTrichophytonrubrum(17,5%) sesont avérés être les pathogènes les plus communs de l’onychomycose.L’onychomycose était plus fréquente chez les patients infectés par le VIH (25,0%).
Conclusion: L’onychomycose était le plus souvent observée chez les adultes de cette étude, par opposition aux personnes âgées dans d’autres régions et T. rubrum et C. albicans étaient les organismes les plus couramment cultivés.
Mots - clés : Onychomycose, infections fongiques, facteurs de risque, trichophyton rubrum, candida albicans
Correspondence: Dr. O.O. Ayanlowo, Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Lagos. Lagos. Nigeria. E-mail: solayan14@gmail.com
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