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  • Presentation

What's New in Treatment of Non-Dermatophyte Molds Onychomycosis

Description

Professor Bianca Maria Pieraccini discussed non-dermatophyte mold onychomycosis, emphasizing its epidemiology in the U.S. and Europe, where different molds such as Aspergillus, Fusarium, and Scopulariopsis are prevalent. The clinical features are distinct, with presentations often involving complete nail diffusion and periungual inflammation, which can help in diagnosing this condition. Accurate diagnosis requires cultures to confirm the presence of non-dermatophyte molds, as they often present with more severe symptoms than dermatophyte infections. Treatment options highlighted include the use of itraconazole and fluconazole, which are more effective than terbinafine, although recent data show variable responses against different species. A combination of systemic antifungal treatment, along with periodic medical or mechanical debridement and topical antifungals, is recommended for managing non-dermatophyte infections. The talk concluded with the importance of ongoing research and adaptation of treatment strategies based on species responsivity.

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Conclusions

  • Non-dermatophyte mold onychomycosis is more prevalent in females than males.
  • Common molds causing onychomycosis in the US include Aspergillus and Fusarium.
  • Clinical features of non-dermatophyte mold onychomycosis differ from typical dermatophyte infections, such as total nail involvement and periungual inflammation.
  • Diagnosis of non-dermatophyte mold onychomycosis requires confirmation of fungal presence through cultures and careful examination of clinical features.
  • Itraconazole and fluconazole are more effective treatments for non-dermatophyte molds compared to terbinafine and griseofulvin.
  • Combined treatment strategies, including antifungal medications and mechanical debridement, yield better outcomes in managing non-dermatophyte mold infections.
  • Scoopulariopsis species may respond better to terbinafine than to other antifungals, indicating the need for tailored treatment approaches.
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