Onychomycosis in patients attending a dermatology outpatient clinic in Lagos, Nigeria

Abstract

Background: Onychomycosis refers to fungal infection of the nails either as a primary event or secondary infection of a previously diseased or traumatized nail. Some of the risk factors associated with onychomycosis include advancing age; smoking; peripheral arterial disease; diabetes mellitus (DM) and immunosuppression. Aim: The work aims to determine the clinical characteristics; predisposing factors, causative organisms in patients with onychomycosis who attended the dermatology clinic in Lagos University Teaching Hospital between July 2013 and Jan 2014. Methods and Materials: This is a prospective observational study. All consenting patients with clinical features suggestive of superficial fungal infections were recruited. Data was collected using a structured questionnaire that contains bio- and socioeconomic data, clinical diagnosis, underlying disease condition and possible predisposing factors. Nail clippings and skin scrapings were taken for KOH microscopy and culture which were by standard methods. Result: Onychomycosis was found in 19.0% of the patients recruited. The infection was most common between the ages of 30 and 39 (21.9%). Finger nail infections were more common affecting 16(61.5%) patients than toenails 6 (23.1%); and combined toe and fingernail infections were found in 4(15.4%). Dermatophytes accounted for 73.1% (19) of the isolates. The yeast Candida albicans (17.5%) and the dermatophyte Trichophyton rubrum (17.5%) were shown to be the most common pathogens of onychomycosis. Onychomycosis was more common in patients with HIV infection (25.0%). Conclusion: Onychomycosis was most commonly seen in the adults in this study as opposed to the elderly in other climes and T. rubrum and C albicans were the most commonly cultured organisms.