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[Clinico-mycological study of onychomycosis in elderly patients]
M E Rodríguez-Soto1, C M Fernández-Andreu, S Moya Duque
1Laboratorio de Micología, Instituto de Medicina Tropical Pedro Kouri (IPK), La Habana, Cuba.
Abstract:
Physical examination of nails was carried out in 210 elderly patients and nail scrapings were obtained from onychomycosis suggested lesions in order to determine their causative agents, incidence and clinical characteristics. Diagnostic was confirmed by the isolation of the agents from 74 patients, mainly from toe-nails (incidence 35.2). Tinea pedis occurred in 25% of the cases and Diabetes mellitus was the most prevalent associated disease and the most frequent clinical characteristics were the thickening, the opacity and the presence of longitudinal strias in the surface of the nails. It was compared the results obtained by microscopic examination and by culture. Trichophyton rubrum was the most common dermatophyte isolated; Candida parapsilosis was dominant among Candida species.
Insights
This study identified causative agents of onychomycosis in 210 elderly patients, finding Trichophyton rubrum and Candida parapsilosis to be most common. Nail thickening and opacity were frequent clinical signs in this elderly population.
Area of Science:
- Dermatology
- Mycology
- Geriatrics
Background:
- Onychomycosis is a common nail fungal infection, particularly in the elderly.
- Understanding causative agents and clinical features is crucial for effective treatment.
Purpose of the Study:
- To determine the causative agents, incidence, and clinical characteristics of onychomycosis in elderly patients.
- To compare diagnostic methods (microscopy vs. culture).
Main Methods:
- Physical examination and nail scrapings from 210 elderly patients with suspected onychomycosis.
- Microscopic examination and fungal culture for agent isolation.
- Clinical data collection on nail appearance and associated diseases.
Main Results:
- Onychomycosis confirmed in 74 patients (35.2%), predominantly affecting toenails.
- Tinea pedis occurred in 25% of cases; Diabetes mellitus was the most prevalent associated disease.
- Common clinical signs included nail thickening, opacity, and longitudinal striae.
- Trichophyton rubrum was the most frequent dermatophyte; Candida parapsilosis dominated Candida isolates.
Conclusions:
- Nail thickening, opacity, and longitudinal striae are key clinical indicators of onychomycosis in the elderly.
- Trichophyton rubrum and Candida parapsilosis are significant causative agents in this demographic.
- Early diagnosis and management are essential, considering associated conditions like diabetes.