Superficial and cutaneous aspergillosis is a rare fungal disease that is restricted to the outer layers of the skin, nails, and the outer auditory canal, infrequently invading the deeper tissue and viscera, particularly in immunocompromised patients. These mycoses are acquired through two main routes: direct traumatic inoculation or inhalation of airborne fungal spores into paranasal sinuses and lungs. Lesions are classified into three categories: otomycosis, onychomycosis, and cutaneous aspergillosis. Superficial and cutaneous aspergillosis occurs less frequently and therefore remains poorly characterized; it usually involves sites of superficial trauma—namely, at or near intravenous entry catheter site, at the point of traumatic inoculation (orthopaedic inoculation, ear-self-cleaning, schizophrenic ear self-injuries), at surgery incision, and at the site of contact with occlusive dressings, especially in burn patients. Onychomycosis and otomycosis are more seen in immunocompetent patients, while cutaneous aspergillosis is widely described among the immunocompromised individuals. This paper is a review of related literature.

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Onychomycosis has been shown to have a higher incidence in cancer patients. Nail toxicity is a quite common side effect of anticancer agents. Taxotere^© is a chemotherapeutic known to cause great incidence of nail change and has a role in subungual suppuration. We report on a 52-year-old woman with breast cancer admitted in our institution for onycholysis. Because of the stage and histology of breast cancer, neoadjuvant chemotherapy was initiated. The patient received 8 cycles of Taxotere and Adriamycin (AT), and she underwent a modified radical mastectomy. Three months later, the patient developed evidence of onycholysis, involving all the fingernails. We observed the following changes in nails of all the digits in both hands: onycholysis, dystrophy, oedema, and exudate. Nail scraping and purulent discharge were collected and cultured on Sabouraud medium. Physical features of the colonies and biochemical tests (Auxacolor^©) revealed <i>Candida guilliermondii</i> as the sole etiologic agent of onychomycosis. This case details an onycholysis in a breast cancer case successfully managed solely with amorolfine lacquer. This clinical and mycological presentation should alert the clinician to the possibility of onychomycosis induced by docetaxel chemotherapy.

A 29-year-old patient with Behçet's disease based on three major criteria (i.e., oral ulceration, genital ulceration, and eye lesion) presented with intractable pruritus associated with pinpoint red nodules involving the hair follicles of the back along with steroid-refractory local treatment. Simple light microscopic examination of a skin scraping revealed fungal contamination, and culture on Sabouraud's medium confirmed Trichophyton rubrum as the agent of folliculitis. Behçet's disease is characterized by recurrent attacks of acute inflammation. Although the diagnosis of sterile folliculitis-like disorder is currently retained among patients with Behçet's disease, especially in the lower part of the body, it resembles dermatophytic folliculitis, which can be related to immunosuppressive therapy. Hence, patients with recalcitrant folliculitis predominating on the back who are receiving immunosuppressive treatment should be evaluated for fungal infection, as recognition of this disease may enable earlier diagnosis and treatment.