Prevalencia de onicomicosis en la patología ungueal determinada por examen directo, cultivo micológico y biopsia

Abstract

Objetivos: Determinar la prevalencia de onicomicosis en la patología ungueal empleando examen directo, cultivo micológico y el estudio histopatológico, en pacientes que acudieron a la consulta dermatológica del Hospital Militar Dr. Carlos Arvelo (HMCA) y de micología en el Hospital Universitario de Caracas (HUC) desde noviembre del 2009 hasta septiembre del 2011. Métodos: Se realizó un estudio transversal prueba versus prueba, incluyendo 76 pacientes con diagnóstico clínico de patología ungueal. Resultados: Edad promedio 54,3 años, femeninas 66%, 32% realiza oficios del hogar, predomino tiempo de evolución crónico. Patologías asociadas: insuficiencia venosa, Hipertensión, Diabetes 2, hipotiroidismo 16%. Patología dermatológica asociada: Tiña pedís 50%. El diagnóstico previo de patología ungueal: onicomicosis 71%. Examen directo con KOH positivo 59%. Cultivo para hongos, 42% aisló algún tipo de hongo (Trichophyton rubrum 16%), 32% muestras estériles y 25% contaminadas. Biopsias de uña reporto 90% algún tipo de patología ungueal, 65% con onicomicosis, 7% onicomicosis y psoriasis. Conclusión y Discusión: No hay asociación significativa entre: patologías asociadas y patología ungueal tampoco entre patología dermatológica y ungueales ni entre onicomicosis y otro tipo de patología ungueal. La sensibilidad Examen directo y cultivo 80 y 82% respectivamente, especificidad 46 y 42%. Sensibilidad y especificidad de Biopsia 84% y 74%. La biopsia es el método ideal para diagnostico de Patología Ungueal.

Prevalence of onicomicosis in ungueal pathology using directly exam mycology cultive and histopathology study SUMMARY. Objetive: Determine the prevalence of onicomicosis in ungueal pathology using direct slide exam, mycological culture and histopathological study, in patients attending to a dermatological clinic at Military Hospital “Dr. Carlos Arvelo” (HMCA) and mycology clinic at the University Hospital of Caracas (HUC) since November 2009 until September 2011. Méthods: We performed a cross-sectional study sample versus sample, of 76 patients with clinical diagnosis of ungueal pathology. Results:. Average age was 54.3 years, 66% were female, 32% were housewives, a chronic evolution was the most common form. Associated diseases included: venous insufficiency, hypertension, diabetes 2, hypothyroidism 16%. Dermatological associated pathology included: Tinea pedis 50%. Previous diagnosis of nail pathology included: Onychomycosis 71%. Direct examination with KOH were positive in 59% of patients. Fungal culture: 42% isolated some type of fungus (Trichophyton rubrum 16%), 32% were sterile and 25% were contaminated. Nail biopsies: 90% reported nail pathology, 65% onychomycosis and 7 % psoriasis associated onychomycosis. Conclusion and Discussion: No significant association were observed between associated pathologies and nail onychomycosis, neither an association between dermatological and other nail pathologies, nor an association between onychomycosis and other kinds of nail pathology were observed. The sensitivity of direct mycological examination and mycological culture were 80 and 82% respectively, and the specificity were 46 and 42% respectively. Biopsy sensitivity and specificity of 84% and 74%. Biopsy is the ideal method for diagnosis of nail pathology.