Evaluation of onychomycosis among diabetic patients of Yazd diabetic center

Background The population suffering from diabetes is increasing all over the world. In Iran, the prevalence of diabetes is reported from 5 to 8 percent and the highest figure is for Yazd and Booshehr Province. In diabetic patients infections of nail and skin pose a great danger. Objective To determine the prevalence of onychomycosis in diabetic patients and its relation with age, gender, period of diabetes and its control. Patients and methods This descriptive study involved 262 diabetic type 2 patients which were referred to the Yazd diabetic clinic during years of 2008 to 2009. All the patients were examined by a dermatologist and the patients with clinical doubt were sent for the laboratory tests i.e. smear and culture. Confirmed cases of onychomycosis were treated with terbinafine 250mg/day for four months. The patients were followed up clinically every month and data were recorded. In the end of treatment protocol, direct smear and culture from nails was taken. Results 262 diabetic patients (123 men and 139 women) were examined. The mean age of patients and diabetic duration were 59.12 ±10.96 years and 7.24±12.8 years, respectively .Onychomycosis was diagnosed clinically in 18 patients (6.9%) and proved by culture only in 10 patients (3.8%). 70% of onychomycosis cases were men and 60% were over 60 years old. No significant relation was found between the frequency of onychomycosis and the diabetic duration but in the patients having a weaker control of diabetes onychomycosis was more frequent. Conclusion The frequency of onychomycosis in diabetic patients type 2 is 3.8% and it had a significant relation with the weak control of diabetes.