RESUMO
A remarkable case of onychomycosis by Trichophyton (T.) rubrum combined with nail infestation by Tyrophagus (T.) putrescentiae in an elderly diabetic farmer is described and discussed. Large numbers of eggs and mites in all development stages were present in nail debris, reflecting active reproduction on site. Treatment with ivermectin 0.1% cream and environmental decontamination cleared the mite infestation, while onychomycosis responded well to oral terbinafine and ciclopirox 8% nail lacquer. Such a combination of onychomycosis and mite infestation of the same nail is an exceptional finding reported only twice in the literature.
Assuntos
Dermatoses do Pé/complicações , Infestações por Ácaros/complicações , Unhas/parasitologia , Onicomicose/complicações , Tinha dos Pés/complicações , Trichophyton/isolamento & purificação , Idoso , Doenças dos Trabalhadores Agrícolas/tratamento farmacológico , Doenças dos Trabalhadores Agrícolas/microbiologia , Criação de Animais Domésticos , Antifúngicos/uso terapêutico , Ciclopirox , Diabetes Mellitus Tipo 2/complicações , Suscetibilidade a Doenças , Dermatoses do Pé/microbiologia , Humanos , Ivermectina/uso terapêutico , Masculino , Naftalenos/uso terapêutico , Onicomicose/microbiologia , Permetrina , Piridonas/uso terapêutico , Sapatos , Terbinafina , Tinha dos Pés/microbiologiaRESUMO
BACKGROUND: There are currently no studies on epidemiology and clinical aspects of nail fungal infections in the general population of Cameroon. PATIENTS AND METHODS: Two series of patients observed at a hospital dermatological service of Yaoundé and in a volunteer service of Douala were evaluated. All the patients, regardless of the reason for the consultation, were examined by an expert dermatologist to discover signs of onychomycosis. Patients with suspected nail lesions underwent mycological examination according to the standard techniques. RESULTS: Among 590 subjects (317 males and 273 females), aged 16-83 years, onychomycosis was mycologically confirmed in 52 cases (8.8%). The infection was most common in the fifth decade. Fingernails were affected in 12 cases, toenails in 30 cases, and both fingernails and toenails in 10 cases. Dermatophytes were isolated in 57.7% of cases, the most common species being Trichophyton rubrum (16 cases) and Trichophyton violaceum (eight cases). Non-dermatophytic mould, including Aspergillus spp., Fusarium spp., and Neoscytalidium dimidiatum, was found in 10 cases. Onychomycosis was more common in patients from low social-economic classes. CONCLUSIONS: This is the first investigation dealing with onychomycosis in Cameroon. These data may be useful for future research and in the development of preventive and educational strategies.