Relationships between the incidence of onychomycosis and nail psoriasis

Sandra Kavaliauskienė¹, Romualda Povilionytė¹, Jūratė Jakubovskienė¹, Daiva Jasaitienė¹, Skaidra Valiukevičienė¹, Renata Petrauskienė¹, Rūta Paulina Zarankienė¹, Erika Skrodenienė², Astra Vitkauskienė²

¹Department of Skin and Venereal Diseases, Kaunas University of Medicine, ²Laboratory of Microbiology, Kaunas University of Medicine, Lithuania

Key words: onychomycosis; psoriasis; dermatophytes; yeasts; moulds.

Summary. The aim of the study was to determine the incidence of onychomycosis in affected nails among psoriatic and nonpsoriatic patients.

Material and methods. The study included 559 patients (168 males and 391 females) examined for fungal infection of nails using direct microscopy and culture tests.

Results. Of the 559 patients, 30 (5.3%) (9 males and 21 females) had psoriasis. The incidence of onychomycosis (determined according to positive results of culture tests) among psoriatic patients was 23.3% (7/30) as compared to 23.6% (125/529) among nonpsoriatic patients (P>0.05). Among psoriatic patients, dermatophytes were detected in 5 (71.4%) of the 7 cases, and in the remaining 2 cases, yeast and yeast-like fungi were found. Among nonpsoriatic patients, dermatophytes, yeast, and mould were detected in 66, 43, and 16 cases of the 125 positive cultures, respectively. The sensitivity of the microscopic examination versus culture for the identified dermatophytes and yeasts was 87.3% and 18.6%, accordingly.

Conclusions. There was no difference in the incidence of onychomycosis and distribution of fungal infections among psoriatic and nonpsoriatic patients. Onychomycosis was detected in less than one-third of the patients with clinically affected nails. The culture test is an important tool in diagnosing onychomycosis and selecting systemic treatment.

Correspondence to S. Kavaliauskienė, Department of Skin and Venereal Diseases, Kaunas University of Medicine, Eivenių 2, 50009 Kaunas, Lithuania. E-mail: sandrakavaliauskiene@yahoo.com

Received 19 January 2009, accepted 3 March 2010