Onychomycosis among cancer patients undergoing chemotherapy in Tehran, Iran: a cross-sectional study

Fatemeh  Fathi; Farhad  Shahi; Alireza  Khosravi; Zahra  Saffarian; Nader  Safarian; Mir Saeed  Yekaninejad; Zoha  Shaka

doi:10.18502/ijm.v17i2.18392

Fatemeh Fathi Department of Dermatology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Farhad Shahi Breast Disease Research Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Alireza Khosravi Department of Microbiology and Immunology, School of Veterinary Medicine, Tehran University, Tehran, Iran
Zahra Saffarian Department of Dermatology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Nader Safarian Haemostasis and Thrombosis Research Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Mir Saeed Yekaninejad Department of Epidemiology, School of Public Heath, Tehran University of Medical Sciences, Tehran, Iran
Zoha Shaka Cancer Research Center, Cancer Institute, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/ijm.v17i2.18392

Keywords: Cancer; Chemotherapy; Onychomycosis

Abstract

Background and Objectives: Due to the persistence of residual fungal elements, onychomycosis tends to have a high recurrence rate. It is essential to determine the etiology and frequency of onychomycosis across various factors. This study aimed to assess the prevalence of onychomycosis and identify its fungal agents in cancer patients undergoing chemotherapy.

Materials and Methods: This cross-sectional study was conducted on cancer patients attending the Oncology Clinic and Cancer Institute of Tehran University of Medical Sciences. Among the 165 patients meeting the inclusion criteria, 75 individ- uals with nail alterations were referred to a dermatologist. Each patient's information, including demographics, disease-relat- ed data, and details about nail involvement, was recorded. When onychomycosis was suspected, nail samples were collected from the deepest part and examined using a light microscope after clarifying with 15% potassium hydroxide (KOH) to detect fungal elements.

Results: The prevalence of onychomycosis was 37.6% (n=62). Among the 75 patients with nail alterations and suspected onychomycosis, 17.3% (n=13) tested negative for pathogenic agents. The most common pathogen was Candida albicans, present in 21% (13/62) of patients with positive onychomycosis. The prevailing nail alteration was onycholysis, affecting 45.3% (34/75) of patients.

Conclusion: Onychomycosis exhibits associations with variables such as gender, age, cancer and chemotherapy.