Total melanonychia caused by <i>Trichophyton rubrum</i> mimicking subungual melanoma

Bae, Soo Hyeon; Kim, Na Hee; Lee, Jee-Bum; Yun, Sook Jung

doi:10.1111/1346-8138.13386

Cited by 6 publications

(21 citation statements)

References 5 publications

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“…In terms of total cases, 44% (n = 59) of them were women and 56% (n = 74) represented men. The mean age of presentation was 45.4 years in a range of 9 to 87 years [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 ].…”

Section: Resultsmentioning

confidence: 99%

“…In terms of occupations, 95% (n = 126) did not have such information, the remaining 5% (n = 7) corresponded to green tea leaf pickers 1.5% (n = 2), activities related to gardening 2% (n = 3), farmers 0.75% (n = 1) and magistrates 0.75% (n = 1) [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 ].…”

Section: Resultsmentioning

confidence: 99%

“…The following background were identified: 11.3% (n = 15) of the cases were related to migration 3.8% (n = 5), cancer 3% (n = 4), nail trauma 1.5% (n = 2), antifungals 0.8% (n = 1), ethnic pigmentation 0.8% (n = 1), longitudinal melanonychia 0.8% (n = 1) and outdoor activity 0.8% (n = 1) [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 ].…”

Section: Resultsmentioning

confidence: 99%

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Fungal Melanonychia: A Systematic Review

Rodríguez-Cerdeira,

Martínez-Herrera,

Cortés-López

et al. 2024

Microorganisms

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Fungal melanonychia is an uncommon condition, most typically caused by opportunistic melanin-producing pigmented filamentous fungi in the nail plate. In the present study, the clinical characteristics of patients diagnosed with fungal melanonychia were analyzed through a systematic review of cases reported in the literature. The MESH terms used for the search were “melanonychia” AND “fungal” OR “fungi” through four databases: PubMed, SciELO, Google scholar and SCOPUS. After discarding inadequate articles using the exclusion criteria, 33 articles with 133 cases were analyzed, of which 44% were women, 56% were men and the age range was between 9 and 87 years. The majority of cases were reported in Turkey followed by Korea and Italy. Frequent causal agents detected were Trichophyton rubrum as non-dematiaceous in 55% and Neoscytalidium dimidiatum as dematiaceous in 8%. Predisposing factors included nail trauma, migration history, employment and/or outdoor activities. Involvement in a single nail was presented in 45% of the cases, while more than one affected nail was identified in 21%, with a range of 2 to 10 nails. Regarding the clinical classification, 41% evidenced more than one type of melanonychia, 21% corresponded to the longitudinal pattern and 13% was of total diffuse type. Likewise, the usual dermoscopic pattern was multicolor pigmentation. It is concluded that fungal melanonychia is an uncommon variant of onychomycosis and the differential diagnosis is broad, which highlights the complexity of this disease.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Fungal Melanonychia: A Systematic Review

Rodríguez-Cerdeira,

Martínez-Herrera,

Cortés-López

et al. 2024

Microorganisms

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“…In our work, Trichophyton rubrum variant melanoid was the most isolated agent of FM, which is in line with previous reports in the current literature where T rubrum was the most common agent detected 10,16 . Trichophyton rubrum produces a soluble, nongranular pigment (melanin or melanin‐like compounds 17,18 ) that impregnates the nail bed like brown to black staining , which can result in a longitudinal band, with distal to proximal spread on the nail plate, rather than diffuse melanonychia, thus further complicating differential diagnosis 10,16 …”

Section: Discussionmentioning

confidence: 99%

Dermatophytic melanonychia: A case series of an increasing disease

Starace

Ambrogio

Bruni

et al. 2021

Mycoses

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Background Melanonychia refers to brown‐black colour pigmentation due to melanin or not‐melanin deposition in the nail plate. Onychoscopy allows to distinguish if the pigmentation is due by melanin or not. The main causes of non‐melanic pigmentation are subungual haematoma and pigmented onychomycosis. Fungal melanonychia (FM) is rare and may present as diffuse or longitudinal pigmentation. Differential diagnosis includes melanic activation, such as ethnic‐type nail pigmentation or frictional melanonychia, but also versus melanic proliferation, such as nevus or nail melanoma. Fungal melanonychia can be due to a colonisation by fungi with black variant or by melanin activation due to inflammation of fungal invasion. Objectives The aim of paper is to increase clinical and dermoscopic knowledge of this increasingly frequent disease. Methods In this retrospective observational study, twenty patients with dermatophytic melanonychia were collected, with available clinical and dermoscopic pictures. The diagnosis of dermatophytic melanonychia was made based on clinical manifestation and mycological examination. KOH smear was performed in all cases. For each patient, clinical data included: age, gender, type of melanonychia and involved fingers. Results This study aimed to show increased incidence of dermatophytic melanonychia and its correct management. In addition, we reviewed our collected cases and described the clinical and dermoscopic features of dermatophytic melanonychia. Conclusions The results of this study showed that physicians should keep in mind the diagnosis of this increasing disease, and that it cannot be performed relying only on clinical grounds. We would like to highlight the importance of tools as KOH examination, culture and dermoscopy.

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“…The pigmentation started as a longitudinal melanonychia, involved the whole nail, was visible through the transparent cuticle and the distal portion of the PNF was mimicking a subungual melanoma. 36 Candida and bacterial infection…”

Section: (A) (B) (C)mentioning

confidence: 99%