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A Review of Onychomycosis Due to Aspergillus Species

Felix Bongomin1,2, C R Batac3, Malcolm D Richardson1,4

  • 1The National Aspergillosis Centre, Education and Research Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Southmoor Road, Manchester, M23 9LT, UK.

Mycopathologia
|November 18, 2017
PubMed

Insights

Aspergillus species are increasingly causing nail infections, known as non-dermatophyte mould onychomycosis. Diagnosis requires microscopy and repeated Aspergillus detection, with treatment involving systemic antifungals.

Area of Science:

  • Medical Mycology
  • Dermatology
  • Infectious Diseases

Background:

  • Aspergillus species are emerging as significant causes of onychomycosis, specifically non-dermatophyte mould onychomycosis (NDMO).
  • Recent discoveries highlight new Aspergillus species capable of causing nail infections.

Purpose of the Study:

  • To review the epidemiology, diagnosis, and clinical presentation of onychomycosis caused by Aspergillus species.
  • To consolidate current knowledge on Aspergillus-related nail infections.

Main Methods:

  • Systematic review of 42 epidemiological studies on onychomycosis.
  • Analysis of diagnostic criteria for Aspergillus onychomycosis.
  • Review of clinical presentations and etiological species.

Main Results:

  • Aspergillus onychomycosis prevalence ranges from <1% to 35% in the general population, rising to 71% in diabetics and the elderly.
  • Toenails are affected 25 times more often than fingernails.
  • Common species include A. flavus, A. terreus, and A. niger; diagnosis requires microscopy and repeated fungal detection.

Conclusions:

  • Aspergillus species are a notable cause of NDMO, particularly in specific demographics.
  • The clinical presentation is often non-specific, commonly showing a distal-lateral pattern.
  • Effective treatment involves systemic terbinafine or itraconazole.
Keywords:
AspergillusClinical featuresEpidemiologyMycologyOnychomycosis

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