Onychomycosis in Tehran, Iran: Prevailing fungi and treatment with itraconazole

A total of 187 Patients with suspected onychomycosis were examined for caus ative fungal agents between 1996 and 1997. Laboratory examination confirmed onychomycosis in 115 patients, of which 97 cases were presented with posit ive microscopic and cultural examinations, and they were selected for itrac onazole pulse therapy. From an etiological point of view, 48.4% of the nail infections, mainly toenail infections, were caused by dermatophytes, 43.3% were infected with Candida spp, specially infected fingernails, and 8.2% b y non-dermatophytic molds. Trichophyton mentagrophytes var. interdigital an d T. violaceum were the most prevalent species. Candida albicans and C. par apsilosis were the predominant species of the Genus Candida. Scopolariopsis brevicaulis was the most common non-dermatophyte molds observed. Female af fected more frequently than male and in both sexes, those who were 30-49 ye ars old, more infected. Toenails were affected more frequently than fingern ails. In this study, itraconazole pulse therapy (400 mg daily) gave during the first week of per month for 3 months. The study included 51 patients wi th toenail onychomychosis (group 1) and 46 patients with fingernail infecti ons (group 2). Patients were followed up for 9 months after the last treatm ent. Clinical response rates were 83% in the group 1, 95% in the group 2 at month 12; the corresponding mycological cure rates were 71 and 87%, respec tively.