Onychomycosis: a significant medical problem.

The importance of onychomycosis is often underestimated. Far more than being a simple cosmetic problem, infected nails serve as a chronic reservoir of infection which can give rise to repeated mycotic infections of the skin. 448 patients with nail abnormalities attending Skin O. P. D of King George Hospital, Visakhapatnam during a 1 (one) year period between November'98-October'99, were subjected to detailed clinical, epidemiological study. Diagnosis was confirmed in 204 cases by direct microscopy or culture or by both. Females (51.96%) were slightly more than the males (48.04%). Majority of the cases were between 21-40 years age group. Housewives (33.33%) were most frequently affected. Trauma was a predisposing factor in 11.27% of the cases. The duration of lesions varied from 3 months to 15 years. In the majority (38.23%) it was less than one year. Candidal onychomycosis was the most prevalent clinical type (58.82%) followed by distal subungual onychomycosis (38.72%). Disease was limited only to finger nails in 57.35% and toe nails in 32.35%. Predominant isolates obtained were candida spp. (56.7%), followed by dermatophytes (38.2%) and non-dermatophyte molds (3.37%). 26.96% of the patients had experienced physical, psychosocial and occupational problems.