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Nondermatophyte mould onychomycosis

A K Gupta1,2, R C Summerbell3,4, M Venkataraman1

  • 1Mediprobe Research Inc., London, ON, Canada.

Journal of the European Academy of Dermatology and Venereology : JEADV
|March 25, 2021
PubMed

Insights

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

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.

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