Clinical and Etiological Study of Onychomycosis in Institutionalized Elderly in Goiânia City, Goiás State, Brazil

Abstract

Background: Onychomycosis is fungal nail infection, which can be associated with some factors, such as decreased nail growth and immunodeficiency, makes the elderly predisposed to onychomycosis. The objective of this study was to investigate the frequency of onychomycosis in elderly institutionalized, and to verify the effects that the infection had in their daily routine. Methods: This study was carried in gerontological complexes of Goiânia, Goiás, Brazil, with 58 elderly who exhibited clinical suspicion of onychomycosis and a questionnaire was provided to the elderly regarding the effects that the infection had in their daily routine. Results: Among the 33 cases of the onychomycosis confirmed, 63.6% were female and 36.4% male. The participant ages ranged from 55 to 86 years (51.3 years ± SD = 32.8). In this study, no statistically significant between age (p = 0.362) and sex (p = 0.234) associated of Onychomycosis in institutionalized elderly. The etiological agents Trichophyton rubrum were isolated in 9.1% and Fusarium spp. in 15% of the positive samples. The genus Candida was identified in 46.5% of the samples, and Candida parapsilosis (30.3%) was the most frequent species. The applied questionnaire verified that more than 90% of participants answered that other people notice the presence of the nail lesion; That the of nail injuries influences their choice of shoes; and that perceive the difference in nail characteristics, such as thickness and discoloration. Conclusions: This study found a higher frequency of onychomycosis in women, and the main etiological agents were Candida spp. and Fusarium spp. The onychomycosis significantly changes the routine of its patients, with most participants reporting that people find it unpleasant to look at their nails and note the problem and they are uncomfortable with the appearance of the lesion. In clinical question, the participants also notice the change in the characteristics of their nails, difficulty in cutting and, nail and finger/toe pain.