Onychomycosis, Tinea Pedis and Tinea Manuum Caused by Non‐Dermatophytic Filamentous Fungi Nicht‐Dermatophyten‐Fadenpilze als Erreger von Onychomykosen, Tinea pedis und Tinea manuum

Abstract

Over 4000 cases of fungal nail, sole and palm infection recorded during a three-year study period were investigated to determine the prevalence and significance of etiologic agents other than dermatophytes and yeasts. Littman's oxgall agar, which permitted isolation of cycloheximide-sensitive species but restricted overgrowth by fast growing contaminants, was used to promote isolation of these disease agents. Non-dermatophytic filamentous fungi made up 2.3 % of the confirmed etiologic agents obtained overall, and constituted 3.3 % of the agents obtained from nail infections. The most common species were Scopulariopsis brevicaulis, Hendersonula toruloidea, and Aspergillus sydowii. Scytalidium hyalinum was recorded for the first time from Canada, and an instance of nail infection by Gymnascella dankaliensis was recorded. Only H. toruloidea and Sc. hyalinum caused palm and sole infections. Zusammenfassung: Uber 4000 Falle von Pilzinfektionen der Nagel, FuBsohlen und Handflachen wurden wahrend eines 3Jah-reszeitraumes auf das Vorkommen von Nicht-Dermatophyten-Fadenpilzen als Erreger untersucht. Zur Isolierung dieser Pilze wurde Littmans Rindergalle-Agar benutzt, der die Isolierung Cycloheximidempfindlicher Arten erlaubt, jedoch das Uberwuchern durch schnellwachsende Kontaminanten verhindert. Nicht-Dermatophyten-Fadenpilze machten 2,3 % der nachgewiesenen Gesamterreger und 3,3 % der Erreger von Nagelinfektionen aus. Die haufigsten Arten waren Scopulariopsis brevicaulis, Hendersonula toruloidea und Aspergillus sydowii. Scytalidium hyalin um wurde dabei zum erstenmal in Canada nachgewiesen, weiterhin wurde eine durch Gymnascella dankuliensis verursachte Nagelmykose gefunden. H. toruloidea und Sc. hyalinum waren bei Palrnar-und Plantarinfektionen alleinige Erreger.

Onychomycosis Insensitive to Systemic Terbinafine and Azole Treatments Reveals Non-Dermatophyte Moulds as Infectious Agents

“…Statistical analyses based on results from cultures vary significantly [4]. For example, 3.3% of the onychomycoses reported in Canada were due to NDF [3]. In contrast, NDF appeared to be more prevalent than dermatophytes in onychomycoses in a US geriatric population [23].…”

“…The most prevalent recognized infectious agent worldwide is Trichophyton rubrum [2]. Although onychomycoses are mainly caused by dermatophytes, various non-dermatophyte filamentous fungi (NDF) are often isolated from abnormal nails and were shown to be the infectious agents [3,4,5,6]. …”

Development and Evaluation of a Novel Real-Time PCR for Pan-Dermatophyte Detection in Nail Specimens

“…The three dermatophyte genera are Trichophyton, Microsporum, and Epidermophyton, and Trichophyton rubrum is the most common pathogenic dermatophyte agent (causing more than 70 % of cases) [4]. Because tinea unguium requires long-term systemic antifungal treatment and different causative agents may require different antifungal agents, the correct identification of a causal fungus is necessary for treatment [5,6].…”

Oral Terbinafine and Itraconazole Treatments against Dermatophytes Appear Not to Favor the Establishment of <b><i>Fusarium</i></b> spp. in Nail

“…The reported prevalence of onychomycosis with NDF following results from cultures varies from one country to another and depends on the type of population and on the laboratory-specific method of investigation [1]. NDF onychomycoses have been reported to account for <3% of total onychomycoses in many epidemiological surveys [2,3,4], while NDF appeared to be more prevalent than dermatophytes in onychomycoses in a geriatric population in the USA [5]. In our records, the frequency of Fusarium isolates from nails was 16% of that seen for dermatophytes (table 1).…”