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Trichophyton erinacei Onychomycosis: The First to Evidence a Proximal Subungual Onychomycosis Pattern
Sutasinee Phaitoonwattanakij1, Charussri Leeyaphan1, Sumanus Bunyaratavej1
1Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Abstract:
Trichophyton erinacei is an emerging cause of dermatophyte infections, which are frequently isolated from hedgehogs. Nail infections from T. erinacei are rarely reported. We describe the case of a 23-year-old Thai female who had a history of systemic lupus erythematosus with lupus nephritis type III and who developed widespread skin and nail infections caused by T. erinacei that were most likely transmitted from a hedgehog. Although the patient did not demonstrate a clinical improvement or mycological cure following systemic itraconazole and fluconazole treatment, she achieved clinical and mycological cures after terbinafine therapy. A drug susceptibility test should be performed in patients with T. erinacei infections to facilitate decision-making about antifungal therapy. Here, we are the first to report a case of proximal subungual onychomycosis from a T. erinacei infection.
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