The importance of mycological investigations in diagnostics of nail changes

Maleszka R, Ratajczak-Stefańska V, Mikulska D

The aim of the study was an analysis of correlation between mycological examination results and clinical features of changed toenails in patients that visited mycological laboratory due to suspected onychomycosis. 
Material and methods: Samples of changed toenails were collected from 579 patients. From all that cases a precise patient’s history was taken paying a special attention on previous antimycotic treatment. In the clinical examination features of toenail changes were estimated. 
Results: Onychomycosis was confirmed by the mycological examination in 23.3% of patients and exclude in 56.3% of individuals. In 20.4% of all cases the fungi growth was not obtained despite of positive results of direct microscopic examination. Among the cultured fungi species the most frequently observed were strains of Trichophyton rubrum – 46.6%. 46% of all patients were previously treated with antifungals but the therapy was not efficacious in 23% of them.
Conclusions: In all the cases of toenail changes it is important to take a precise patient’s history, because it has an essential influence on the results of diagnostic examinations. 
Diagnosing onychomycosis one cannot rely only on the clinical examination because in over 50% of patients with typical for onychomycosis toenail changes the mycological examination do not confirm fungal infection.