A clinical and mycological study of onychomycosis in HIV infection.
Indian J Dermatol Venereol Leprol
;
2007 Nov-Dec; 73(6): 397-401
Article
in English
| IMSEAR
| ID: sea-52963
ABSTRACT
BACKGROUND:
Onychomycosis is one of the early manifestations of HIV infection with a prevalence of 15-40%. Multiple nail involvement, isolation of both common and rare species and resistance to treatment are the characteristics of onychomycosis in HIV.AIM:
To study the epidemiology, clinical manifestations of onychomycosis in HIV-infected individuals and to identify the various causative fungi microbiologically.METHODS:
A total of 250 HIV infected patients, diagnosed by ELISA, were screened for nail involvement; of which 60 patients i.e, 40 males and 20 females, who had clinically suspected untreated fungal infection were included in this study.RESULTS:
Of the 60 respondents, 34 (56.66%) were from the 31-40 years age group. Amongst the 40 males, there were 20 manual laborers and 14 farmers; while 18 of 20 females were housewives. Toenail involvement was seen in 38 patients (63.33%), fingernail in 12 patients (20%) while 10 (16.66%) patients had involvement of both. Twenty eight (46.66%) patients gave history of some trauma, 6 (10%) had diabetes mellitus and only 1 patient (1.66%) had history of peripheral vascular disease. Nineteen (31.66%) patients had associated tinea pedis, 5 (8.33%) had tinea manuum, 10 (16.66%) had tinea corporis and 7 (11.66%) had tinea cruris. Twenty one (35%) respondents had distal and lateral superficial onychomycosis (DLSO), 5 (8.33%) had proximal subungual onychomycosis (PSO), 1 (1.66%) had superficial white onychomycosis (SWO), while 33 (55%) had total dystrophic onychomycosis (TDO). Fungal elements were demonstrated by KOH mount in 49 patients (81.66%) and growth was seen in 32 (53.33%) cultures. Dermatophytes were isolated in 13 (21.66%) and nondermatophytic molds (NDM) in 19 (31.66%). Out of the 13 positive dermatophyte cultures, Trichophyton rubrum was isolated on 11 and Trichophyton mentagrophytes on 2 cultures. Of the 19 non-dermatophytic cultures, Aspergillus niger was isolated on 3 and Candida spp. on 12 while Cladosporium spp, Scytalidium hyalinum, Penicillium spp. and Gymnoascus dankaliensis on 1 each.CONCLUSIONS:
Total dystrophic onychomycosis was the most common clinical type and NDM were the predominant causative organisms.
Full text:
Available
Index:
IMSEAR (South-East Asia)
Main subject:
Tinea
/
Female
/
Humans
/
Male
/
HIV Infections
/
Peripheral Vascular Diseases
/
AIDS-Related Opportunistic Infections
/
Onychomycosis
/
Adult
/
Mitosporic Fungi
Type of study:
Practice guideline
/
Prognostic study
Country/Region as subject:
Asia
Language:
English
Journal:
Indian J Dermatol Venereol Leprol
Year:
2007
Type:
Article
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