Toenail onychomycosis in EstoniaZehennagel-Onychomykose in Estland


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Abstract

SummaryThe aim of our study was to evaluate the clinical features, predisposing factors and pathogens of toenail onychomycosis in Estonia. During study period we interviewed and examined 436 dermatological patients with clinical signs of toenail onychomycosis in all counties of Estonia. In 69% of cases, the clinical diagnosis of onychomycosis was confirmed by the mycological analysis. The most common clinical symptoms of onychomycosis both in mycologically proven and non-proven cases were discolorization of nail plate, hyperkeratosis and brittle nails. The number of infected toenails positively correlated with patients' age. On average, patient had 5.4 infected nails. In 78% of culture-positive cases, a dermatophyte was isolated as the causative agent, in 10% yeasts and in 7% moulds. In 6% of culture-positive cases we reported mixed infections. Trichophyton rubrum was the most common pathogen. The high occurrence of mixed infections, clinical symptoms characteristic to long lasting or chronic infection and high number of infected toenails indicate that Estonian patients have more advanced stage of toenail onychomycosis compared with other western and central European countries.ZusammenfassungZiel der Untersuchung waren Erhebungen zur Zehennagel-Onychomykose in Estland. Insgesamt wurden 436 Patienten mit klinischen Merkmalen der Zehennagel-Onychomykose (Verfärbung der Negelplatte, Hyperkeratose und brüchige Nägel) aus ganz Estland in die Studie eingeschlossen. Bei 69% der Probanden wurde eine Zehennagel-Onychomykose mykologisch belegt. Infizierte Zehennägel und Alter der Patienten waren positiv korreliert. In 78% wurden Dermatophyten, in 10% Hefen und in 7% Schimmelpilze als Erreger isoliert. 6% waren Mischinfektionen. Trichophyton rubrum war der am häufigsten isolierte Erreger. Die Ergebnisse werden mit Erhebungen in Zentral- und Westeuropa verglichen.

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