Onychomycosis in the Military Hospital of Marrakesh: A Five-year Experience
Year: 2021
Type: article
Study design: Observational Study
Abstract: Onychomycosis is a nail fungal infection caused by dermatophytes, becoming one of the most frequent reasons for consultation in mycological dermatology in Morocco. The purpose of this work is to describe the epidemiology of onychomycosis and to specify the most frequently isolated fungal agents in the Avicenna Military Hospital of Marrakesh. This is a retrospective study that included 875 patients and took place in the Avicenna Military Hospital of Marrakesh over a period of 5 years. Direct examination on a slide with a coverslip after clarification with potassium hydroxide (KOH 30%), as well as culture on Sabouraud media supplemented with chloramphenicol and chloramphenicol with cycloheximide were systematically carried out. Incubation was carried out in 20-25°C for dermatophytes and 37°C for yeasts and molds. The tubes were regularly controlled (twice a week) for at least four weeks before giving negative results. Between January 2015 and July 2019, 875 patients were enrolled in this study. Sex ratio (M:F) was 1.06. The average age was 48 years. Toenails were affected in 683 cases (78%), fingernails in 192 cases (21.9%), and both fingernails and toenails in 120 cases (13.7%). Pachyonychia was present in 63% of the cases (551/875), subungual hyperkeratosis in 50.8% of the cases (444/875) and xanthonychia in 43% of them (376/875). 61% (625 / 875) of direct examinations were positive, of which 83% (522/625) were confirmed by positive culture. Dermatophytes were isolated in 86.8% of the cases (n=759), yeasts in 13% (n=113) and molds in 0.2% of the cases (n=2). Candida albicans was the only identified yeast in this series (13%), found mainly in fingernails. In addition, toenail onyxis was mainly caused by dermatophytes. Trichophyton rubrum and Trichophyton mentagrophytes var interdigital represented 80.8% and 6% of isolated dermatophytes, respectively. This work attests the contribution of mycological examination to the confirmation of fungal origin of onychopathies and the treatment orientation. Trichophyton rubrum was isolated in the majority of our cases.
Authors: Fatima Babokh, Zineb Nassiri, El Mostafa El Mezouari, Redouane Moutaj
Language: English
Topic: Nail Diseases and Treatments
Subfield: Dermatology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W3210032836