Aspectos epidemiológicos, clínicos e laboratoriais das onicomicoses em Fortaleza-Ceará

Abstract

Introduction: Onychomycosis is a fungal infection in nails caused by dermatophytes, yeasts and moulds, accounting about 50% of the onicopathies. The clinical diagnosis of onychomycosis must be confínned through laboratory diagnosis. The aim of this study was to know the clinical, epidemiological and laboratorial aspects of onychomycosis in studied population and to evaluate the importance of serial repetition of direct microscopy and fungal culture in the diagnosis of onychomycosis. Methods: In the retrospective study, the test data were analyzed and the incidence of onychomycosis and the fungus isolated in fingernails and toenails was noted. In the prospective study, the patients were clinically evaluated and separated in two groups. The group I was submitted to simple mycological test and the group II was submitted to three successive mycological tests, in which the ungual residues were scraped off and submitted to direct microscopy examination and fungal culture. Results: Onychomycosis was more frequent in females than in males, between ages of 40 and 60 years. Fingernails were the most frequent anatomic site. The most frequent clinical presentation in the fingernails were onycholysis, paronychia and wrinkleness and in toenails were onycholysis and subungual hyperkeratosis. Distal and lateral subungual onychomycosis was the most clinical form. In the prospective study, when only one collection of material for examination was made, the incidence of onychomycosis was 25.04%, while in the prospective shidy, the examination of trhee samples was considered with 37.7% of positive results obtained. The most isolated fungi, in both studies were yeasts from the genera Candida, with a low percentage ofdemiatophytes. Conclusion: The present study demonstrated that yeasts are predominant in Fortaleza and that the serial repetition of direct microscopy and fungal culture, conducted at shrot intervals of time, is very important in the diagnosis of onychomychosis. Thus, this practice must be established to achieve a better and more accurate diagnosis.