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Nondermatophyte mould onychomycosis.

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Diagnosing nondermatophyte mould (NDM) onychomycosis requires careful mycological testing. Effective treatments include systemic antifungals like itraconazole and terbinafine, with newer agents for resistant cases.

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Area of Science:

  • Medical Mycology
  • Dermatology
  • Infectious Diseases

Background:

  • Nondermatophyte mould (NDM) onychomycosis presents diagnostic challenges due to NDMs often being mistaken for contaminants.
  • The incidence of NDM and mixed infections (dermatophytes plus NDMs) causing onychomycosis is increasing.
  • Accurate clinical diagnosis combined with mycological testing is crucial for effective management.

Purpose of the Study:

  • To review diagnostic approaches for NDM onychomycosis.
  • To summarize current and emerging treatment strategies for NDM onychomycosis.
  • To highlight the importance of antifungal susceptibility testing in managing resistant infections.

Main Methods:

  • Review of existing literature on NDM onychomycosis diagnosis and treatment.
  • Analysis of diagnostic methods, including repeated laboratory isolation.
  • Evaluation of systemic and topical antifungal therapies, including newer azoles and combination treatments.

Main Results:

  • Repeated laboratory isolation is key to confirming NDM pathogenicity.
  • Systemic antifungals like itraconazole and terbinafine show efficacy against common NDMs.
  • Limited studies exist on topical therapies, and antifungal resistance is a growing concern.
  • Newer azoles (posaconazole, voriconazole) and combination therapies show promise for recalcitrant NDM onychomycosis.

Conclusions:

  • Accurate diagnosis and mycological testing are essential for NDM onychomycosis.
  • Systemic antifungals are primary treatment options, with newer agents and combination therapies for resistant cases.
  • Antifungal susceptibility testing should be considered for managing difficult-to-treat NDM onychomycosis.