Background: Onychomycosis is by far the most frequent cause of nail disease. We describe epidemiological and mycological features observed in the Tunis area in Tunisia.
Material and methods: Data were collected from 292 nail samples performed in 255 patients with suspected onychomycosis.
Results: Request for samples were made late, on the average 48 months after development of nail disorders. Most of the patients were women (63.5%). One hundred ninety-six samples were positive (67%), 130 from toe nails and 66 from finger nails. Simultaneous infections of both finger and toe nails were found in 22 cases. Associated onychomycosis and skin mycosis was found preferentially in feet onychomycosis. The sensitivities of direct examination and culture depended on the site of the onychomycosis. Cultures were more sensitive for hands where yeasts, particularly Candida albicans, predominated, but the direct examination was more sensitive for feet where dermatophytes, particularly Trichophyton rubrum, predominated.
Conclusion: Mycological examination is compulsory for confirmation of onychomycosis. It is also recommended before initiating a costly long-term treatment.