Onychomycosis Incidence in Type 2 Diabetes Mellitus Patients

Overview

Journal Mycopathologia

Specialties Microbiology
Pharmacology

Date 2008 Apr 1

PMID 18373212

Citations 14

Authors

Patricia Manzano-Gayosso

Francisca Hernandez-Hernandez

Luis Javier Mendez-Tovar

Yanni Palacios-Morales

Erika Cordova-Martinez

Elva Bazan-Mora

Ruben Lopez-Martinez

Affiliations

Soon will be listed here.

Abstract

The onychomycosis incidence was determined in 250 type 2 diabetes mellitus (T2DM) patients who were registered at the Internal Medicine Service from a Mexico city General Hospital throughout a year (January-December 2006). Out of the total of studied T2DM patients, 93 (37.2%) showed ungual dystrophy and from these, in 75.3% a fungal etiology was corroborated. Out of 70 patients, 34 were men and 36 women, with an average of 63.5 years. Correlation between T2DM evolution time and onychomycosis was significant (P < 0.01). Distal-lateral subungual and total dystrophic onychomycosis were the most frequent clinical types (55.1% and 33.7%, respectively). Fifty-eight fungal isolates were obtained; 48.6% corresponded to dermatophytes, Trichophyton rubrum being the first species (37.1%). All these strains corresponded to two morphological varieties: "yellow" and typical downy. From the yeast-like isolates, 12 corresponded to Candida spp., firstly C. albicans and C. parapsilosis; three to Cryptococcus spp. (C. albidus, C. uniguttulatus and C. laurentii); two Trichosporon asahii; and only one to Pichia ohmeri. Six non-dermatophytic molds were isolated: two Chrysosporium keratinophylus, two Scopulariopsis brevicaulis, one Aspergillus fumigatus, and one Acremonium sp. The fungal mixture corresponded to T. mentagrophytes with C. guilliermondii; T. mentagrophytes with C. glabrata; T. rubrum with C. glabrata; T. rubrum with P. ohmeri.

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References

Mugge C, Haustein U, Nenoff P . [Causative agents of onychomycosis--a retrospective study]. J Dtsch Dermatol Ges. 2006; 4(3):218-28. DOI: 10.1111/j.1610-0387.2006.05877.x. View

Baran R, Hay R, Tosti A, Haneke E . A new classification of onychomycosis. Br J Dermatol. 1999; 139(4):567-71. DOI: 10.1046/j.1365-2133.1998.02449.x. View

Perez M, KOHN S . Cutaneous manifestations of diabetes mellitus. J Am Acad Dermatol. 1994; 30(4):519-31; quiz 532-4. DOI: 10.1016/s0190-9622(94)70058-3. View

Rich P . Special patient populations: onychomycosis in the diabetic patient. J Am Acad Dermatol. 1996; 35(3 Pt 2):S10-2. DOI: 10.1016/s0190-9622(96)90063-8. View

Ilkit M . Onychomycosis in Adana, Turkey: a 5-year study. Int J Dermatol. 2005; 44(10):851-4. DOI: 10.1111/j.1365-4632.2005.02265.x. View

Gales A, Pfaller M, Houston A, Joly S, Sullivan D, Coleman D . Identification of Candida dubliniensis based on temperature and utilization of xylose and alpha-methyl-D-glucoside as determined with the API 20C AUX and vitek YBC systems. J Clin Microbiol. 1999; 37(12):3804-8. PMC: 85818. DOI: 10.1128/JCM.37.12.3804-3808.1999. View

Faergemann J, Baran R . Epidemiology, clinical presentation and diagnosis of onychomycosis. Br J Dermatol. 2003; 149 Suppl 65:1-4. DOI: 10.1046/j.1365-2133.149.s65.4.x. View

Khan Z, Ahmad S, Mokaddas E, Chandy R . Tobacco agar, a new medium for differentiating Candida dubliniensis from Candida albicans. J Clin Microbiol. 2004; 42(10):4796-8. PMC: 522288. DOI: 10.1128/JCM.42.10.4796-4798.2004. View

Romano C, Gianni C, Difonzo E . Retrospective study of onychomycosis in Italy: 1985-2000. Mycoses. 2005; 48(1):42-4. DOI: 10.1111/j.1439-0507.2004.01066.x. View

10.

Tosti A, Piraccini B, Lorenzi S . Onychomycosis caused by nondermatophytic molds: clinical features and response to treatment of 59 cases. J Am Acad Dermatol. 2000; 42(2 Pt 1):217-24. DOI: 10.1016/S0190-9622(00)90129-4. View

11.

LEVY L . Epidemiology of onychomycosis in special-risk populations. J Am Podiatr Med Assoc. 1998; 87(12):546-50. DOI: 10.7547/87507315-87-12-546. View

12.

Elewski B, Charif M . Prevalence of onychomycosis in patients attending a dermatology clinic in northeastern Ohio for other conditions. Arch Dermatol. 1997; 133(9):1172-3. View

13.

Alvarez M, Gonzalez L, Castro L . Onychomycosis in Cali, Colombia. Mycopathologia. 2004; 158(2):181-6. DOI: 10.1023/b:myco.0000041866.85314.e4. View

14.

Pierard G, Pierard-Franchimont C . The nail under fungal siege in patients with type II diabetes mellitus. Mycoses. 2005; 48(5):339-42. DOI: 10.1111/j.1439-0507.2005.01140.x. View

15.

Mendez-Tovar L, Anides-Fonseca A, Vazquez-Hernandez A, Galindo-Gonzalez M, Diaz-Madrid M, Berdon-Castro A . [Micosis among five highly underprivileged Mexican communities]. Gac Med Mex. 2006; 142(5):381-6. View

16.

Staib P, Morschhauser J . Chlamydospore formation on Staib agar as a species-specific characteristic of Candida dubliniensis. Mycoses. 1999; 42(9-10):521-4. DOI: 10.1046/j.1439-0507.1999.00516.x. View

17.

Gupta A, Konnikov N, Macdonald P, Rich P, Rodger N, Edmonds M . Prevalence and epidemiology of toenail onychomycosis in diabetic subjects: a multicentre survey. Br J Dermatol. 1999; 139(4):665-71. DOI: 10.1046/j.1365-2133.1998.02464.x. View

18.

Mosca C, Moragues M, Llovo J, Al Mosaid A, Coleman D, Ponton J . Casein agar: a useful medium for differentiating Candida dubliniensis from Candida albicans. J Clin Microbiol. 2003; 41(3):1259-62. PMC: 150262. DOI: 10.1128/JCM.41.3.1259-1262.2003. View

19.

Membreno Mann J, Zonana Nacach A . [Diabetes mellitus: causes for hospitalization, intrahospital complications and mortality]. Rev Med Inst Mex Seguro Soc. 2005; 43(2):97-101. View

20.

Gupta A, Ryder J, Baran R, Summerbell R . Non-dermatophyte onychomycosis. Dermatol Clin. 2003; 21(2):257-68. DOI: 10.1016/s0733-8635(02)00086-4. View