Tinea unguium in Lahore, Pakistan

During a period of 1 year, out of 202 clinically suspected cases of tinea unguium, 53 (26%) were confirmed by mycological cultures for dermatophytes. Trichophyton rubrum was the most common fungus isolated in 46 (87%) patients, followed by T. violaceum in four (7%), T. interdigitale in two (4%) and Epidermophyton floccosum in one (2%). The disease was more common in adult males and fingernails were found to be affected more often than toenails. The distal and lateral variety was seen in 41 (77%) patients, total secondary dystrophic type in 11 (21%) and proximal subungual type in one (2%). Clinical diagnosis alone is not reliable and mycological confirmation is mandatory for this potentially curable disease.