Onychomycoses constitute pathologies frequently seen in dermatological practice worldwide. Usually, they are caused by two groups of pathogenic fungi: dermatophytes and yeasts of the Candida genus. However, in a small fraction of the cases, the etiologic agents comprise nondermatophyte molds, belonging to several genera and species. The objective of this study was to present two cases of onychomycosis associated to the mold Scytalidium dimidiatum in patients residing in two cities of Santa Catarina State, Brazil. Aspects of fungal pathogenesis, as well as the epidemiological characteristics and laboratory diagnosis, are discussed.

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Figura 1: Pápulas eritematosas com diâmetros variados na região perioral, nasal e palpebral inferiorFigure 1: Erythematous papules with varied diameters in the perioral, nasal and lower eyelid regions.HISTÓRIA DA DOENÇA Paciente do sexo masculino, 16 anos, branco, estudante, natural e procedente de Palhoça, SC; procurou o ambulatório de dermatologia com queixa de lesões "acneiformes" na face, assintomáticas, há aproximadamente dois meses. Havia sido tratado com tetraciclina 1g/dia por 30 dias e dexametasona creme, sem melhora clínica. Negava doenças pregressas e casos semelhantes na família.Ao exame dermatológico, apresentava pápulas eritematosas, algumas com centro amarelado, variando entre dois e 4mm de diâmetro nas pálpebras inferiores, região nasal e perioral (Figuras 1, 2 e 3).A histopatologia de uma das lesões evidenciou, na derme, granulomas constituídos por histiócitos epitelióides, células gigantes, linfócitos e necrose central. Apresentava também infiltrado mononuclear perivascular e perianexial (Figuras 4 e 5). COMENTÁRIOSCom os dados obtidos na história e no exame físico HISTORY OF THE DISEASEA 16-year old white male student, born and living in Palhoça, Santa Catarina State sought care two months ago at the dermatology outpatients clinic. He complained of acneiform lesions on the face, which were asymptomatic. He had been treated with tetracycline, 1g daily over 30 days and dexametasone cream, without showing any clinical improvement. He denied having had previous diseases or similar cases in his family.The dermatological exam showed ery t h e m a t o u s papules, some with a yellow center, varying from two to 4mm in diameter on the lower eyelids, nasal and perioral regions (Figures 1, 2 and 3).Histopathology of one lesion evidenced granulomas on the skin constituted by epithelioid histiocytes, giant cells, lymphocytes and central necrosis. The granulomas also showed perivascular and perianexial mononuclear infiltrate (Figures 4 and 5). COMMENTSThe data obtained from the disease history and Caso para diagnóstico / Case for diagnosis Garlindo, Souza Filho, Ta r n o w s k y, Schacker, Duarte & Bastos 2 3 5 An bras Dermatol, Rio de Janeiro, 78(2):235-238, mar. / a b r. 2003.