Onychomycosis in HIV Infection� A Clinicomycological Profile

Dr. Gatha M Upadya

Volume : V, Issue : XI, November - 2015

Onychomycosis in HIV Infection� A Clinicomycological Profile

Dr. Gatha M Upadya

Abstract :

 Context: Onychomycosis refers to the fungal infection of the nail bed and secondarily of the nail plate. In HIV infection it is characterized by being clinically more aggressive, with rapid spread to the feet and hands, having higher frequency of proximal white subungual type. Setting and design: The study was conducted for a period of 12 months. During this period a total of 325 HIV positive patients who attended the dermatology out patients department were screened for the features of onychomycosis and 48 clinically diagnosed cases of onychomycosis were selected for the study. 40 HIV negative cases with onychomycosis were selected as controls. Aim: To find out the clinical pattern of onychomycosis in HIV infected individuals with special reference to common site affected, type of onychomycosis and to isolate the pathogens responsible for the disease and to compare it with the control group. Methods and Materials: 48 clinically diagnosed cases of onychomycosis with HIV were taken into study. Nails were examined clinically to find out the pattern of involvement. Nail clippings were subjected to KOH direct microscopy and fungal culture.40 patients with onychomycosis who were negative for HIV were taken as controls. Statistical analysis: P value was found out using Fisher’s exact test Results: Commonest age group affected was 25–34 years (45.80%). Thickening and opacification of nails was the commonest presentation noted. Toe nails either alone or with finger nails affected in 79.15%.Distal and lateral subungual onychomycosis was the commonest clinical type found in 33 (82.5%) patients. Proximal subungual onychomycosis alone was seen in 2(4.16%) and combination in 4(8.33%) patients whereas that was not observed in any of the patients in the control group. Direct microscopy of the nail clipping was positive in 19(39.50%) patients and culture was positive in 15(31.25%).Trichophyton Ruum in 6(40%), Candida Albicans in 5(33.33%) were the important pathogens isolated. Conclusion: In our study thickening and opacification of the nail was the commonest nail change with toe nail involvement in most of the cases. PSOM was seen only in HIV with Trichophyton Ruum as the main pathogen.