title: Onychomycosis in Iran: epidemiology, causative agents and clinical features.
abstract: BACKGROUND
  Onychomycosis represents the most frequently encountered nail disease, which is difficult to eradicate with drug treatment.
  
  
  OBJECTIVE
  This study was undertaken to document the clinico-mycological pattern of onychomycosis in Iran. Results of mycological tests of nail scrapings collected over a 4-year period were analyzed.
  
  
  METHODS
  Both direct microscopy and cultures of the nail material were performed to identify the causative agents.
  
  
  RESULTS
  The microscopic and/or cultural detection of fungi was positive in 40.2% of samples. The most common clinical type noted was distolateral subungual onychomycosis in 48.4% of cases. Etiological fungal agents were 50% dermatophytes, 46.8% yeasts, and 3.2% saprophytic moulds. The most frequently detected dermatophyte species were Trichophyton rubrum (48.4%) and T. mentagrophytes (41.9%). Among yeasts, Candida albicans (58.6) was most common, followed by C. parapsilosis (17.2%), C. glabrata (10.3%), C. krusei and C. tropicalis (each 6.9%). Aspergillus niger and A. flavus were the most frequent saprophytic moulds. Females were affected more frequently than males, and in both sexes those most infected were between 40-49 years of age. Fingernails were affected more frequently than toenails.
  
  
  CONCLUSIONS
  The clinico-epidemiological data collected can serve as reference for future research and may be useful in the development of preventive and educational strategies.
authors.affiliation: Medical Parasitology and Mycology Department, Qazvin University of Medical Sciences and Health Services, Qazvin, Iran.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Aghamirian
authors.forename: Seyed Amir
authors.initials: SA
authors.lastname: Ghiasian
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001230:Aspergillus / Q000302:isolation & purification*; D002175:Candida / Q000302:isolation & purification*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005533:Foot Dermatoses / Q000453:epidemiology* / Q000382:microbiology*; D006229:Hand Dermatoses / Q000453:epidemiology* / Q000382:microbiology*; D006801:Humans; D007223:Infant; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D014009:Onychomycosis / Q000453:epidemiology* / Q000382:microbiology*; D015995:Prevalence; D012737:Sex Factors; D014249:Trichophyton / Q000302:isolation & purification*; D055815:Young Adult