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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Background and Aim: Bacteria are one of the causes of nail infections. Although nail infections are not always associated with a major health problem, their treatment, particularly in immunosuppressed patients could be chalenging. This study was conducted to investigate the prevalence of bacterial agents in patients with dystrophic nails referred  to mycology laboratory of Razi Hospital, Tehran.

Methods: This was a cross-sectional study on patients with dystrophic nail. Samples were examined by both direct examination and culture. Blood agar and eosin methylene blue (EMB) agar media were used to culture and differentiate bacteria.

Results: Of 700 dystrophic nail samples, 183 (26.1%) samples were diagnosed as onychomycosis. One hundred and four (56.8%) of the patients were female. One hundred and eighty-one patients had bacterial nail infection (25.9%), of whom 109 (60.2%) were female. Forty-six (6.6%) patients had both bacterial and fungul infections, of whom 32 (69.6%) were female. The most common detected agent was Staphylococci.

Conclusion: Bacterial infections can result in dystrophioc nails. If these infections remain untreated they can lead to nail loss. In most cases, treatment of bacterial nail infections is easier than fungul nail infections.