الفهرس 
acknowledgmentOnly 14 pages are availabe for public view
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Abstract
Onychomycosis is common and undoubtedly constitutes one of the major causes of nail dystrophy. As compared with other superficial mycoses, this entity is a more persistent and intractable condition and spontaneous remissions are rare. It poses a serious concern to the clinician because .of its extreme recalcitrance to becomes a chronic source of infection which can cause recurrent . therapy and dystrophic changes of the affected nails. Moreover, it superficial mycotic infections of the skin. Therefore, the eradication of fungal nail infection is very important. When fungal infection is , suspected, specimens for confirmation of the diagnosis should be obtained before treatment is started because several dermatological conditions produce nail changes that mimic onychomycosis. So, this work aimed to study the value of correct lab. diagnosis in estimation of the prevalence of onychomycosis among nail dystrophies clinically suspected as fungal infections through studying: . The role of fluorescent brightness in rapid and accurate screening of fungi in direct microscopic examination ofonychomycotic nails. Sensitivity of direct microscopic examination by KOH and culture in diagnosis of onychomycosis. . The role of histopathologic examination of the nail in accurate diagnosis of onychomycosis. . Coincidence of bacterial infection in cases of associated chronic paronychia. The present work included 212 patient clinically suspected to have onychomycosis attended the mycology out patient clinic of the Main University Hospital of Alexandria. from October 1995 to September 1996, in addition to patients reffered from some private clinics. Detailed history including, name, age, sex, occupation, residence, metabolic disorders, renal diseases, malignancy, immunologic disturbances and peripheral vascular diseases were taken. History about the duration of nail dystrophy, evidence of disolouration, thickening or ridging, the site of nail involvement, paronychia, skin lesions in other parts of the body, similar condItions in other members of the family or among their human contacts, skin lesions in pets or domestic animals, history of antibiotic, steroid, antimitotic I therapy were also included. or antifungal (local or systemic) Clinical examination was done including site (finger or toenail or both), number, clinical type of nail involvement, ridging, thickening and evidence of discolouration followed by examination of the surrounding skin as well as the other skin of the body. The specimens were taken by two methods from each lesion site: Nail plate clipping, by using nail clipper and subungual scraping of the nail derbis by using a small curette. In addition to swabbing of the nail fold for bacteriological examination only in cases of chronic paronychia. The nail plate clippings were processed for histopathological examination and stained with tI &. E and PAS stains. When PAS stained sections were negative for fungi, KONCPA” methoq was performed. I’ The subungual scraping were divided into three portions for 30 KOIi examination by light microscopy, the second portion for ’I fluorescent microscopic examination using 0.1 CalcofIour white /I; stain and the third portion was cultured on SDA with 0.05 mg/mL 11, chloramphenical, and 0.5 m gm/m I cyclohexamide and on littman:s oxgall agar. The media were incubated at 25° for up to 6 weeks. Isolates were identified by gross morphology, microscopic examination and some additional tests.