STUDY OF ONYCHOMYCOSIS IN CORDOBA, SPAIN - PREVAILING FUNGI AND PATTERN OF INFECTION

From a total of 20 004 patients seen during two years, we carried out a mycologic nail investigation (direct microscopy and repeated culture s). Ninety-three (43.2%) of the nails were judged to be infected by th eir clinical appearance. They fulfilled the laboratory criteria requir ed to start antifungal treatment (isolation of the same fungus in cult ure on two consecutive occasions), but only in 64 cases (29.7%) was th ere a clinical and mycological recovery once antifungal treatment and follow up were completed. Yeasts were isolated in two thirds of the ca ses of onychomycosis, mainly from fingernails. Candida albicans, C. pa rapsilosis or both were the most prevalent species. Dermatophytes were found in 18.8% of the samples, especially from toenails. Trichophyton rubrum was the predominant species. Non-dermatophytic filamentous fun gi were cultured in 17.2%, Scopulariopsis brevicaulis being the most p revalent species. The highest prevalence of onychomycosis was found in patients between 50 and 70 years of age. Females were affected more f requently than males. Fingernails were affected more frequently than t oenails. Proximal subungual onychomycosis, secondary to paronychia (PS Op), was the most prevalent clinical type, although primary distal and lateral subungual onychomycosis (DLSO) and total dystrophic onychomyc osis (TDO) were also frequent. PSOp was only observed in fingernails, while DLSO was almost only seen in toenails and TDO in both fingernail s and toenails. All the clinical types were more frequent in women exc ept TDO, which showed a similar prevalence in both sexes.