ONYCHOMYCOSIS: UNRAVELING THE ROLE OF DERMATOPHYTES IN NAIL INFECTIONS
DOI:
https://doi.org/10.22159/ijpps.2025v17i2.52892Keywords:
Onychomycosis, Dermatophytes, Fungal infection, KOH mount, Nail cultureAbstract
Objective: This study aimed to identify pathogenic fungi that cause onychomycosis and evaluate their clinical presentations and risk factors to enhance management through precise diagnosis and targeted treatment.
Methods: The fungi were identified by macroscopic and microscopic morphological features using techniques such as slide cultures, Potassium Hydroxide (KOH) mounts, culture isolation, and Lacto Phenol Cotton Blue (LPCB) staining.
Results: 110 nail clippings from patients clinically suspected of onychomycosis were analyzed; 27 had dermatophytic infections. Toenails were involved in 33.8% of the cases, and Distal and Lateral Subungual Onychomycosis (DLSO) was the primary clinical presentation. Trauma was the most common predisposing factor (19%).
Conclusion: This study identified dermatophytes as the prime cause of onychomycosis, chiefly affecting toenails with DLSO as the predominant form, and recognized trauma as a key risk factor. Precise identification using traditional diagnostic methods is crucial for targeted treatment and better patient results.
Downloads
References
Chander J. Textbook of medical mycology. Mehta Publishers; 2009.
Jartarkar SR, Patil A, Goldust Y, Cockerell CJ, Schwartz RA, Grabbe S. Pathogenesis immunology and management of dermatophytosis. J Fungi (Basel). 2021;8(1):39. doi: 10.3390/jof8010039, PMID 35049979.
Razavyoon T, Hashemi SJ, Mansouri P, Rafat Z, Saboor Yaraghi AA, Kamali Sarvestani H. The epidemiology and etiology of onychomycosis in 2 laboratory centers affiliated to Tehran university of Medical Sciences during 2019-2020. Iran J Microbiol. 2022;14(2):268-75. doi: 10.18502/ijm.v14i2.9196, PMID 35765553.
Saxena G, Sadawarte K, Kulmi M, Mehta A. A study of pattern of onychomycosis in A Tertiary Care Hospital of Central India. Int J Pharm Pharm Sci. 2022;14(5):36-41. doi: 10.22159/ijpps.2022v14i5.44465.
Elewski BE, Tosti A. Risk factors and comorbidities for onychomycosis: implications for treatment with topical therapy. J Clin Aesthet Dermatol. 2015;8(11):38-42. PMID 26705439.
Piraccini BM, Starace M, Rubin AI, DI Chiacchio NG, Iorizzo M, Rigopoulos D. Onychomycosis: recommendations for diagnosis assessment of treatment efficacy and specialist referral the consonance consensus project. Dermatol Ther (Heidelb). 2022;12(4):885-98. doi: 10.1007/s13555-022-00698-x, PMID 35262878.
Siddiqui SM, Phulari YJ, Hiremath RN, Patil C, Patel P. A clinico mycological evaluation of dermatophytic infections a single centre prospective observational study. Asian J Pharm Clin Res. 2022;15(4):122-6. doi: 10.22159/ajpcr.2022.v15i4.44454.
Saha I, Podder I, Chowdhury SN, Bhattacharya S. Clinico mycological profile of treatment-naive chronic recurrent and steroid modified dermatophytosis at A Tertiary Care Centre in Eastern India: an institution based cross-sectional study. Indian Dermatol Online J. 2021;12(5):714-21. doi: 10.4103/idoj.IDOJ_909_20, PMID 34667758.
Deng R, Wang X, LI R. Dermatophyte infection: from fungal pathogenicity to host immune responses. Front Immunol. 2023;14:1285887. doi: 10.3389/fimmu.2023.1285887, PMID 38022599.
Mahmood HR, Shams Ghahfarokhi M, Salehi Z, Razzaghi Abyaneh M. Epidemiological trends antifungal drug susceptibility and SQLE point mutations in etiologic species of human dermatophytosis in Al-Diwaneyah Iraq. Sci Rep. 2024;14(1):12669. doi: 10.1038/s41598-024-63425-w, PMID 38830918.
Jha B, Sharma M, GC S, Sapkota J. Onychomycosis among clinically suspected cases attending the dermatology out-patient department of a tertiary care centre: a descriptive cross-sectional study. JNMA J Nepal Med Assoc. 2021;59(237):450-3. doi: 10.31729/jnma.6277, PMID 34508426.
Sundari IB, Kalva S, Bindu M. Development of efinaconazole nail gel for the treatment of onchomycosis. Int J Curr Pharm Res. 2023;15(6):109-12. doi: 10.22159/ijcpr.2023v15i6.3092.
Segal E, Elad D. Human and zoonotic dermatophytoses: epidemiological aspects. Front Microbiol. 2021;12(3):713532. doi: 10.3389/fmicb.2021.713532, PMID 34421872.
Foley K, Gupta AK, Versteeg S, Mays R, Villanueva E, John D. Topical and device based treatments for fungal infections of the toenails. Cochrane Database Syst Rev. 2020;1(1):CD012093. doi: 10.1002/14651858.CD012093.pub2, PMID 31978269.
Muthulatha A, Bhanupriya T, Srikanth S. Onychomycosis as a cause of onychodystrophy: a narrative review. Annals of SBV. 2022;11(2):39-44. doi: 10.5005/jp-journals-10085-9111.
Leung AK, Lam JM, Leong KF, Hon KL, Barankin B, Leung AA. Onychomycosis: an updated review. Recent Pat Inflamm Allergy Drug Discov. 2020;14(1):32-45. doi: 10.2174/1872213X13666191026090713, PMID 31738146.
Trovato L, Calvo M, DE Pasquale R, Scalia G, Oliveri S. Prevalence of onychomycosis in diabetic patients: a case control study performed at university hospital policlinico in Catania. J Fungi (Basel). 2022 Aug 30;8(9):922. doi: 10.3390/jof8090922, PMID 36135647.
Published
How to Cite
Issue
Section
Copyright (c) 2025 IQBAL AHMED, RAHIL PASHA S. A., SADIYA NOOR HAJIRA, ASMIYA PARVEEN
This work is licensed under a Creative Commons Attribution 4.0 International License.