IJSR International Journal of Scientific Research 2277 - 8179 Indian Society for Health and Advanced Research ijsr-9-4-24849 Original Research Paper NON-DERMATOPHYTIC ONYCHOMYCOSIS: MYCOLOGICAL OVERVIEW FROM A TERTIARY CARE CENTRE. NIKHITA C VED Dr. April 2020 9 4 01 02 ABSTRACT

INTRODUCTION: Onychomycosis accounts to almost 50% of all the nail disorders. Dermatophytes are implicated to be their most common etiological agents as they have the ability to survive on the human keratin layers. Non–dermatophytes are generally considered as either contaminants or commensals, however, their significance in causing onychomycosis have been increasingly reported. The etiological agents of onychomycosis changes with respect to geographical area. This study was conducted to understand the mycological spectrum of onychomycosis and the role of non–dermatophytes in causing the disease. METHODOLOGY: All the specimens obtained were subjected to microscopy, after treatment with 40% KOH. The specimens were also inoculated onto Sabouraud’s dextrose agar with and without cycloheximide and incubated at 25°C and 37°C upto 4 weeks. The tubes were examined twice weekly and fungal growths were identified according to standard procedures. RESULTS: During the study period 37 cases were reported. There was a male preponderance (67.6%) over female (32.4%). Finger nails (26/37, 70.3%) were more affected than toe nails (11/37, 29.7%). Direct microscopy of nail clippings in 40% KOH was positive in 20/37 (54%) cases and fungal culture was positive in 26/37 (70%) of cases. Aspergillus niger was the most common isolate (n=12), followed by Cladosporium species (n=4). Trichophyton species were identified in only n=3 cases. CONCLUSION: Being aware of the spectrum of agents causing onychomycosis in a particular region becomes important to keep a broad–minded approach for the possible pathogens. This will help in providing early and appropriate treatment to the patient thereby reducing the patient’s morbidity and mortality in the long run. Our study reported an increase in trend of onychomycosis caused due to non–dermatophytic moulds, hence these agents should also be considered as pathogens instead of mere contaminants or secondary colonisers.