Onychomycosis

Baran, Robert; Haneke, E; Hay, Roderick J.; Piraccini, Bianca Maria; Tosti, Antonella

doi:10.1201/9780367804381

Cited by 2 publications

(5 citation statements)

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“…84,85 Some NDMs have a few distinct clinical features; for example, an infection caused by Acremonium might present with longitudinal thin streaks, Scopulariopsis brevicaulis may exhibit brown discolouration, while Neoscytalidium is capable of invading the surrounding skin and producing concurrent tinea pedis or paronychia. 81,86,87 Superficial onychomycosis (SO) can be further categorized as superficial white onychomycosis (SWO) and superficial black onychomycosis (SBO) based on the colour of the lesion. Although rare, SBO has been associated with NDM aetiological agents such as Neoscytalidium dimidiatum.…”

Section: N Ica L Pr E Se N Tationmentioning

confidence: 99%

“…3 TDO is an advanced form of onychomycosis often involving most of the nail plate and nail bed; it may involve multiple digits. 87 NDMs causing TDO include Aspergillus, but have been reported with other NDMs as well. 92 Cases of TDO may occur in the immunocompromised (e.g.…”

Section: N Ica L Pr E Se N Tationmentioning

confidence: 99%

“…Patients presenting with concurrent tinea pedis (plantaris or interdigitalis variant) are associated with a higher risk of DLSO than is seen in patients with nail trauma 84,85 . Some NDMs have a few distinct clinical features; for example, an infection caused by Acremonium might present with longitudinal thin streaks, Scopulariopsis brevicaulis may exhibit brown discolouration, while Neoscytalidium is capable of invading the surrounding skin and producing concurrent tinea pedis or paronychia 81,86,87 …”

Section: Clinical Presentationmentioning

confidence: 99%

“…Superficial onychomycosis (SO) can be further categorized as superficial white onychomycosis (SWO) and superficial black onychomycosis (SBO) based on the colour of the lesion. Although rare, SBO has been associated with NDM aetiological agents such as Neoscytalidium dimidiatum 87 . SWO has been seen with Aspergillus, Fusarium and Acremonium infections 86,88–90 .…”

Section: Clinical Presentationmentioning

confidence: 99%

“…Although rare, SBO has been associated with NDM aetiological agents such as Neoscytalidium dimidiatum. 87 SWO has been seen with Aspergillus, Fusarium and Acremonium infections. 86,[88][89][90] Although SWO was thought to be confined primarily to the superficial nail plate, some (2) dual invasion SWO, involving both the proximal nail fold and ventral aspect of the eponychial segment; and (3) pseudo-SWO, which is a deep and diffuse penetration of the nail plate.…”

Section: N Ica L Pr E Se N Tationmentioning

confidence: 99%

See 4 more Smart Citations

A comprehensive review of nondermatophyte mould onychomycosis: Epidemiology, diagnosis and management

Gupta,

Wang,

Cooper

et al. 2023

Acad Dermatol Venereol

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Nondermatophyte moulds (NDMs) are widely distributed and can be detected in association with mycotic nails; however, sometimes it can be challenging to establish the role of NDMs in the pathogenesis of onychomycosis (i.e. causative vs. contaminant). In studies where the ongoing invasive presence of NDMs is confirmed through repeat cultures, the global prevalence of NDMs in onychomycosis patients is estimated at 6.9% with the 3 most common genus being: Aspergillus, Scopulariopsis and Fusarium. NDM onychomycosis can, in many cases, appear clinically indistinguishable from dermatophyte onychomycosis. Clinical features suggestive of NDMs include proximal subungual onychomycosis with paronychia associated with Aspergillus spp., Fusarium spp. and Scopulariopsis brevicaulis, as well as superficial white onychomycosis in a deep and diffused pattern associated with Aspergillus and Fusarium. Longitudinal streaks seen in patients with distal and lateral onychomycosis may serve as an additional indicator. For diagnosis, light microscopic examination should demonstrate fungal filaments consistent with an NDM with at least two independent isolations in the absence of a dermatophyte; the advent of molecular testing combined with histological assessment may serve as an alternative with improved sensitivity and turnover time. In most instances, antifungal susceptibility testing has limited value. Information on effective treatments for NDM onychomycosis is relatively scarce, unlike the situation in the study of dermatophyte onychomycosis. Terbinafine and itraconazole therapy (continuous and pulsed) appear effective to varying extents for treating onychomycosis caused by Aspergillus, Fusarium or Scopulariopsis. There is scant literature on oral treatments for Neoscytalidium.

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