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2023, Number 2

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Dermatología Cosmética, Médica y Quirúrgica 2023; 21 (2)

Onychomycosis: clinical features and causative agents in patients undergoing renal function replacement therapy with hemodialysis

San Juan-Romero A, Rodríguez-Castro A, Férnandez-Martínez RF, Vega-Sánchez DC, Arenas R

Language: Spanish
References: 14
Page: 121-125
PDF size: 163.77 Kb.


ABSTRACT

Objective: to determine the clinical variety and the most frequent causative agents of onychomycosis in patients with kdigo g5 chronic kidney disease on renal function replacement therapy with hemodialysis at the hemodialysis unit of the General Hospital of Queretaro issste in the period July-September 2021.
Material and methods: a prospective study was made with a population of patients who attended renal function replacement therapy with hemodialysis in the period July-September 2021. Nails were reviewed and samples were taken for direct examination and culture of those that presented changes suggestive of fungal infection. In addition, the main demographic characteristics of the patients were obtained.
Results: ninety-two patients were studied, of which only 32 presented a positive direct examination. Men represented 68% and women 32%. The mean age was 62 years (34-87 years). The most common clinical form was distal subungual onychomycosis (34.4%), followed by total dystrophic onychomycosis (25%), and distal and lateral subungual onychomycosis (15.6%). Mixed forms were present in 25% of the cases. The direct examination was positive for filaments in 96.9% and spores in 3.1%. Development in the culture was obtained only in 18.8% of the cases. The cultivated colonies were dermatophyte in 12.5%, Trichophyton rubrum identified as the causative agent and in the remaining 6.2% Acremonium spp.
Conclusions: onychomycosis in hemodialysis patients is a frequent condition with a predominance of males. The most frequent clinical form is distal subungual onychomycosis, confirmed by koh and with development of T. rubrum and Acremonium spp. in culture. Given the high prevalence of this disease, patients must be examined periodically for detection and treatment.


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