Clinico-Mycological Study of Onychomycosis and Pattern of Drug Resistance

ABSTRACT

Introduction: Onychomycosis is a fungal infection of thetoenails or fingernails that may involve any component of thenail unit, including the matrix, bed, or plate. Onychomycosisis caused by dermatophyte fungi, non dermatophyte mouldsand yeasts. Prevalence rates for OM varying from 3 to 5%have been found in most studies; however, a few reportssuggest a higher prevalence of even up to 26% in the generalpopulation. Hence through this study an attempt was made toidentify the various clinical patterns of onychomycosis and toidentify pattern of drug resistance in onychomycosis.Material and methods: The proposed study was carriedout in Outpatient Department of Dermatology Venereologyand Leprosy, Rohilkhand Medical College and Hospital,Bareilly, a tertiary care hospital in western Uttar Pradeshfor one year (November 2017- October 2018) on patientshowing nail changes suggestive of onychomycosis, usingdirect microscopy using potassium hydroxide. The culturemedium SDA with chloramphenicol was used. Sensitivity toTerbinafine, Fluconazole, Itraconazole and Griseofulvine wasstudied.Result: The most common pattern of onychomycosis seenwas distal lateral subungual onychomycosis. Pattern of drugresistance is maximum with Griseofulvin (49%) and least withTerbinafine (20%).Conclusion: A total of 104 patients were enrolled, withmean age 35.93 years. Males were more commonly involvedcompared to females. The culture results were positive among55 patients and negative in 49 patients. The most commoncausative agent isolated was dermatophyte moulds followedby non-dermatophytes and yeasts.