[Onychomycoses due to molds].

Area of Science:

• Medical Mycology
• Dermatology
• Infectious Diseases

Background:

• Onychomycoses constitute approximately 30% of superficial fungal infections seen in dermatology clinics.
• Dermatophytes cause about 50% of onychomycoses, primarily affecting toenails, while yeasts are more common on fingernails.
• Non-dermatophytic molds are infrequently implicated in nail infections, accounting for 2-17% of cases, and their role as primary pathogens versus colonizers requires careful evaluation.

Purpose of the Study:

• To differentiate between onychomycoses caused by pseudodermatophytes and those caused by true filamentous fungi.
• To emphasize the critical role of mycology and histopathology in confirming fungal pathogenicity in nail infections.
• To discuss the challenges and current approaches in treating onychomycoses caused by non-dermatophytic molds.

Main Methods:

• Review of literature on fungal nail infections.
• Emphasis on diagnostic accuracy through mycological and histopathological analyses.
• Clinical evaluation of treatment strategies for non-dermatophytic mold onychomycoses.

Main Results:

• Accurate identification of the causative fungal species is crucial for determining pathogenicity, especially for non-dermatophytic molds.
• Distinguishing between true pathogens and colonizers like saprophytic molds is essential before initiating treatment.
• Treatment efficacy depends on the identified species, lesion severity, and patient factors.

Conclusions:

• Non-dermatophytic molds, including pseudodermatophytes and filamentous fungi, present diagnostic and therapeutic challenges in onychomycosis.
• Laboratory diagnostics are vital for confirming fungal parasitism and guiding treatment decisions.
• Treatment often involves debridement and topical antifungals, with systemic therapy considered in severe cases.