ABSTRACT
BACKGROUND: Onychomycosis is mainly caused by dermatophytes, but yeasts and nondermatophyte molds have also been implicated, giving rise to diverse clinical presentations. The aetiological agents of the disease may show geographic variation. AIM: The aim of the present study was to isolate the causative pathogens and to correlate the various clinical patterns of onychomycosis with causative pathogens. MATERIALS AND METHODS: The study population comprised 170 patients with clinical suspicion of onychomycosis. Nail samples were collected for direct microscopic examination and culture. Clinical patterns were noted and correlated with causative pathogens. RESULTS: Out of total 170 cases included in the study, 140 (82.4%) were positive by microscopy and 77 (45.3%) showed positive mycological findings by both microscopy and culture. The male: female ratio was 1:2.5 and the mean age was 35.29 ± 16.47 years. Fingernails were involved in 51.9%, toenails in 28.6% and both fingernails and toenails in 19.5% of the 77 patients. The clinical types noted were distal lateral subungual onychomycosis (71.4%), proximal subungual onychomycosis (10.4%), total dystrophic onychomycosis (10.4%), superficial white onychomycosis (3.9%) and mixed pattern onychomycosis (3.9%). Yeasts were the most common pathogens isolated, being found in 36 patients (46.8%) followed by nondermatophyte molds which were isolated from 28 patients (36.4%) followed by dermatophytes which were isolated from 13 patients (16.9%). CONCLUSION: Distal lateral subungual onychomycosis was the most common clinical presentation. Candida albicans, Aspergillus species and Tricophyton rubrum were the major pathogens. A single pathogen can give rise to more than one clinical type.
ABSTRACT
BACKGROUND: Atopic dermatitis is an inflammatory skin disorder. Although it is not a life threatening condition, it may become infected with microorganisms, especially in children. OBJECTIVES: The aim of this study was to determine bacterial colonisation in children with atopic dermatitis. METHODS: A total of 80 children were randomly included in this study. Two swabs were taken from each child, one from the eczematous skin lesion and the other from apparently healthy skin, as a control. Bacteria were isolated and identified on the basis of the colonial morphology, gram staining and the Vitek System. RESULTS: The mean age of children in this study was 1.4 years, with no gender difference (p=0.98) (n=80). A total of 240 bacterial colonies were grown from atopic dermatitis lesions in contrast to 193 colonies from non-lesional skin. Gram-positive cocci were found in 78 (97.5%) lesions and in 77 (96.2%) non-lesional skin. Staphylococci species were significantly detected in the lesions than in the non-lesional skin. Ent. Faecalis, Ent. Faecium, Ent. gallinarium and C. minutissium were significantly isolated from lesions as compared to non-lesional skin, whereas C. xerosis was insignificantly found to be more in the lesions (p=0.21). Gram-negative bacteria were isolated from 7(8.8%) lesions, but none were isolated from non-lesional skin. Recovered species were Pantoea agglomerans, Enterobacter cloacae, Chryseobacterium indologenes and Acinetobacter Iwoffii. CONCLUSION: Atopic dermatitis in children is complicated with streptococcal and gram-negative bacterial colonisations and the latter was correlated with the severity of the lesions. Enterococci and Corynebacterium species were significant residents. S. aureus remained the chief inhabitant. No causal relationship could be established between the skin microbiota and atopic dermatitis.
