Total Dystrophic Onychomycosis of All the Nails Caused by Non-dermatophyte Fungal Species: A Case Report

Nikitha, Settipally; Kondraganti, Neha; Kandi, Venkataramana

doi:10.7759/cureus.29765

Cited by 5 publications

(6 citation statements)

References 11 publications

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“…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. HIV infection).…”

Section: N Ica L Pr E Se N Tationmentioning

confidence: 99%

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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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“…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. HIV infection).…”

Section: N Ica L Pr E Se N Tationmentioning

confidence: 99%

“…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: Clinical Presentationmentioning

confidence: 99%

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

Gupta,

Wang,

Cooper

et al. 2023

Acad Dermatol Venereol

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“…She had history of uncontrolled hypertension for many years, and as a part of her occupation she worked with tobacco leaves. 16 KOH mounts of nal scrapings showed septate hyphae and cultures on SDA after three days showed fast greyish white colonies turning black on 10 th day, lactophenol blude munts revealed hyphae bearing dark colored curved conidia. Considering the age, present clinical condition, and potential side effects of the antifungal therapy, no treatment was initiated for the patient.…”

Section: Onychomycosis In Telanganamentioning

confidence: 99%

Onychomycosis in India and Other Countries in the Indian Subcontinent

Gugnani

2024

IHRJ

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Onychomycosis is described as the fungal infection of finger or toenails, the nail plate with dermatophytes, non-dermatophytes, or yeasts. It affects approximately 5% of the population worldwide, and the prevalence in India is reported to vary from 0.5% to 5%. Onychomycosis (OM) is an intriguing problem for dermatologists around the world. The commonest dermatophytes causing nail infections are Trichophyton rubrum, T. mentagrophytes and Epidermophyton floccosum. The aim of present review is to describe salient demographic and clinical features of onychomycosis in different countries in the Indian subcontinent. The various factors including occupations predisposing to causing onychomycosis are also dealt with.

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“…interdigitale, or non-dermatophytes, including Acremonium , Fusarium , or Aspergillus species [7]. Total dystrophic onychomycosis is generally due to non-dermatophyte molds [8]. Finally, endonyx onychomycosis seems to be unique to Trichophyton soudanense nail invasion and may potentially indicate the strong affinity of this species for rigid keratins [9].…”

Section: Introductionmentioning

confidence: 99%

CO2 Laser-Assisted Nail Sampling for Mycological Testing in Onychomycosis

Gnesotto,

Cannata,

Pavan

et al. 2024

Skin Appendage Disord

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Introduction: Onychomycosis is the most common nail infection, predominantly caused by Trichophyton spp., and is divided into four main types. Confirmatory testing is crucial, but obtaining an adequate sample may be challenging. We suggest the use of carbon dioxide (CO2) laser for painlessly detaching the nail plate during mycological examination and ensuring a sufficient specimen. Methods: We retrospectively enrolled 25 patients with distolateral onychomycosis, treated according to the following protocol: (1) multiple passes of CO2 laser at 10 W in continuous mode along the proximal border of the affected nail plate; (2) the nail plate was gently cut; (3) the nail bed was curetted; (4) subungual debris and plate fragments were collected for KOH test and culture. Results: The mean visual analog score (VAS) for pain experienced during the procedure was 0.7 (SD: 2.1), indicating that the sampling was relatively painless for the majority of patients. There were no permanent changes observed in the nail unit of any patients during the follow-up visits as a result of using the CO2 laser. Conclusion: We firmly believe that the use of lasers offers numerous advantages, including ease of use, reduced pain perception, and the ability to target the proximal margin of fungal infections where viable hyphae are significantly represented.

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Total Dystrophic Onychomycosis of All the Nails Caused by Non-dermatophyte Fungal Species: A Case Report

Cited by 5 publications

References 11 publications

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

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

Onychomycosis in India and Other Countries in the Indian Subcontinent

CO<sub>2</sub> Laser-Assisted Nail Sampling for Mycological Testing in Onychomycosis

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