Journal of

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Background and Aim: Tinea unguium is a common disease with worldwide distribution most commonly seen in adult patients. Trichophyton rubrum and T. interdigital are the most common causes. The aim of this study was to investigate the frequency of tinea unguium causative agents in a referral dermatology hospital in Tehran, Iran. Methods: This cross sectional study was conducted in 2010 and 2011 on clinically suspicious patients for tinea unguium referred to the Mycology Laboratory, Razi Hospital, Tehran, Iran. Samples from 700 patients were examined using direct smear microscopy and culture. Direct microscopic examination of the specimens was carried out using 20% potassium hydroxide solution. The specimens were cultured on Sabourad dextrose agar culture media containing chloramphenicol and cyclohexamid (Scc). For identifying the species of dermatophytes, complementary tests were used. Frequencies and relative frequencies were demonstrated in tables and chi-square and Fisher's exact tests were used to investigate any association between the categorical variables. Results: Of 700 dystrophic nail samples, 53 samples (7.6%) were positive according to both direct examination and culture. Thirty-eight patients were males. The most common clinical type was distal subungual onychomycosis which was observed in 79.2% of cases. The most frequent detected dermatophyte species. was T. interdigital (39.6%) followed by T. rubrum (37.7%). Forty-seven patients had tinea unguium on their toe nails, 4 patients on their finger nails, and 2 patients had it on both finger and toe nails. Nineteen patients had underlying diseases, and the most common underlying disease was cardiovascular disease (26.3%). Conclusion: Tinea unguium is a disease with worldwide distribution and identifying the causative agents and predisposing factors are necessary for better management of the patients.

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Onychomycosis is a nail infection caused by dermatophyte and non-dermatophyte molds and yeasts. The nail involvement is a feature of psoriasis, although skin manifestations are the most principal findings in psoriasis. Onychomycosis and psoriasis are both common disorders in communities. It is possible that in some patients these two diseases are present at the same time. A review was performed using the keywords including nail psoriasis, onychomycoses, dermatophytes, non-dermatophyte molds and yeasts in valid medical databases, such as PubMed, Google scholar, Scopus and Science direct. Articles that were most relevant to the purpose of the study were selected and studied. We investigated the incidence and pathogenic function of fungal agents in causing fungal infections in psoriasis nails.

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Background and Aim: Considering the increase of dermatophytosis trough the Iran and world as well, especially ringworm of the body and groin due to terbinafine-resistant species and the high speed of disease transmission, in order to choose the appropriate treatment, considering the time required for the treatment of the disease and early detection of resistant cases treatment is required. The present study was conducted to determine the antifungal sensitivity of Trichophyton rubrum, Microsporum canis and Epidermophyton flucosum strains to common antifungal drugs.
 

Methods: Antifungal sensitivity test (broth microdilution) was performed for 20 specimens obtained from patients according to CLSI (Clinical and Laboratory Standard Institute) M38-3^rd ED protocol, for terbinafine, itraconazole and voriconazole.
 

Results: According to the antifungal susceptibility test results, 5 patients were resistant to terbinafine and showed a minimum inhibitory concentration more than 2, 3 patients were tolerant to terbinafine and showed a minimum inhibitory concentration between 0.5 and 1. Based on the results of the antifungal susceptibility test, 7 patients were tolerant to itraconazole and showed the minimum inhibitory concentration between 0.5 and 1. All isolates responded well to voriconazole.
 

Conclusion: The results of the antifungal sensitivity test highlight the importance of mycological tests on dermatophytic skin lesions to prevent the spread of drug-resistant species.