[Report of 34 cases of saprophytic fungi isolated from dystrophic nails of patients referred to Razi Hospital [2010 - 2011]]

Saprophytes are one of the agents causing nail dystrophy. Saprophytes can invade healthy nail or may invade nails previously damaged in the course of other diseases and grow with suitable conditions. The reported incidence of saprophytic nails is between 1.43-17.6%. Saprophytes preferably invade the nails on the big toes, especially in individuals above 60 years. The most etiologic agents of saprophyte nail are Aspergillus spp, Acremonium spp, Scopulariopsis spp, Penicillium spp, and fusarium. The purpose of this study was to determine the prevalence agents of saprophytic nails in patient that had referred to Razi hospital. This was a cross sectional study and nail samples were analyzed by direct microscopy and culture. Microscopic examination of these specimens was carried out in potassium hydroxide solution [20%]. These specimens were cultured on two media of sabourad dextrose Agar [S]. Czapek-Dox Agar [CZA] medium was used for identification of Aspergillus species. For investigation of relevance between the variables, Chi-square test and Fisher exact tests were used. In this study, 34 cases were positive by both direct microscopy and culture. Of those, 17 patients were females and 17 patients were males. The most frequently isolated saprophytes from nails was Aspergilus flavous [35.3%]. Meanwhile 58.8% of saprophytes were isolated from toe nails. In this study the distal subungual onychomycosis was the most frequent [% 64.7%]. The age group 50-59 years [29.4%] had the highest prevalence of saprophytic nail infections.In this study the prevalence of saprophytic nails infections was 17.2%. A proper diagnosis, consisting of both clinical and mycological examinations, may aid the clinician in selecting the most appropriate therapy. Knowledge of epidemiology and mycology characteristics of nail infections has been noted by many authors as being an important tool for control of these fungal infections

[Investigation of serum C-reactive protein and mannose binding lectin levels in patients with dermatophytosis]

Dermatophytosis is common cutaneous fungal disease with worldwide distribution. Interleukin8 [IL-8] realized from keratinocytes in the presence of dermatophytic antigens causes induction of acute responses in dermatophyte infection and subsequently production of acute phase proteins occurs in hepatocytes. C-reactive protein [CRP] and Mannose binding lectin [MBL] are acute phase proteins. Since few researches in the case of acute phase proteins in dermatophytic infections has been accomplished, this study has been designed for determining serum CRP and MBL levels in patients affected to dermatophytosis. This was a cross sectional study and samples were carried out on 96 healthy individuals and 105 patients affected to dermatophytosis with non probable and in access procedure. For isolation and identification of dermatophyte direct microscopic examination, culturing and complementary examinations were done and for determination of serum CRP and MBL levels in healthy individuals and in patients ELISA test were used. For investigation of relevance between variables, Chi-square, Fisher exact, Mann-Whitney and Roc curve analysis were used and p<0.05 was considered as meaningful level. The median serum CRP level in healthy individuals and in patients group was 3.31 +/- 3.32 micro g/ml and 16.60 +/- 35.96 micro g/ml [p<0.001] respectively and the median serum MBL level was 1.53 +/- 1.87 micro g/ml and 1.97 +/- 2.03 micro g/ml [p=0.039] respectively. CRP [p<0.001] and MBL [p=0.042] were determined meaningful parameters for dermatophytosis. MBL deficiency [MBL concentrations<1 micro g/ml] was higher in control subjects [56.2%] than in patients [41.0%]. Findings of this study indicate increased concentrations of CRP and MBL in patients affected to dermatophytosis and their role in this infection. Probably observation of high frequency of MBL deficiency in healthy individuals in compare with patients group indicates that it is not predisposing factor in affecting to dermatophytosis