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Mycological Profile of Onychomycosis: A Four-Year Retrospective Analysis from a Tertiary Care Center in South India
Arthi Elumalai * , Ashitha Darique
Department of Microbiology, Pondicherry Institute of Medical Sciences, Puducherry, India
Abstract:   (3 Views)
Introduction: Onychomycosis (OM) is the most common nail disorder, accounting for up to 50% of nail dystrophies. The global prevalence of OM is 5.5%, and India has a reported prevalence ranging from 0.5% to 5% across different regions. The most common agents of OM are dermatophytes, particularly Trichophyton rubrum and Trichophyton interdigitale. However, Indian literature shows considerable variability in the clinical presentations and the etiological spectrum. This study was conducted to determine the clinical presentations and mycological profile of OM in a tertiary care setting in South India. Methods: This retrospective descriptive study, conducted over a 4-year period, reviewed records of patients attending the dermatology clinic with a clinical suspicion of OM from January 2020 to December 2023. Nail samples were processed using standard microscopic and culture methods. Results: Of the 172 patients with clinically suspected OM included in the study, 78 (45.3%) were laboratory-confirmed by potassium hydroxide (KOH) microscopy and/or fungal culture. Females predominated, with a male-to-female ratio of 1:1.8. Fingernails were the most commonly affected site, with fingernail involvement observed in 55.8% of the clinically suspected cases. Distal lateral subungual onychomycosis (DLSO) was the predominant clinical presentation, accounting for 55.8% of the clinically suspected cases. Among the fungal isolates, Candida spp. were the most frequently isolated (54.7% of the 64 culture-positive isolates), followed by Fusarium spp. (25.0%). Dermatophytes were isolated in only 3.1% of the culture-positive isolates (n = 2, both identified as T. rubrum). Conclusion: This study demonstrates predominance of non-dermatophyte molds (NDMs) and Candida spp. over dermatophytes among culture-positive isolates in our specific tertiary care setting, which contrasts with several earlier Indian studies that reported dermatophyte predominance. These findings suggest that NDMs and Candida spp. may be important fungal isolates in OM in similar settings, although their pathogenic significance, particularly for NDMs and yeasts, requires careful clinical and laboratory correlation.
 
Keywords: Onychomycosis, Candida, Non-dermatophyte molds, India, Fusarium
     
Type of Study: Original article | Subject: Epidemiologic studies including microbial genotyping, phenotyping and serotyping
Received: 2025/07/8 | Accepted: 2026/02/21
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Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.