Onychomycosis in two geographically distinct regions in India

Background: Onychomycosis is worldwide in distribution and the genera of causative agents are diverse. This study was carried out to demonstrate if the causative agents differed with a difference in temperature, climate and locale. Methods: Seventy patients in coastal tropical region of Karnataka and fifty patients in the hilly temperate region of Sikkim with clinical signs of onychomycosis attending the deramtology outpatient department were included. Inclusion criteria - patients with clinical features suggestive of onychomycosis like roughening, thickening, discolouration, who had given their consent after being informed about the study, were included in the study. Exclusion criteria - Patients on prior antifungal therapy (> 4 weeks) and those with lichen planus, psoriasis, allergic dermatitis were excluded from the study.The screening of the nail clippings was done by microscopy and confirmed by culture. Findings: Fusarium Spp was the most common isolate (45.5%) in Karnataka and Dermatophyte (61.1%) in Sikkim. Conclusion: Different geographical regions may have different etiological agents. The role of non dermatophytes in the etiology of onychomycosis should not be overlooked.