Nail Alternariosis – Synergism with Dermatophytes?

Overview

Presented paper informs about clinical course and treatment of bilateral toenail disease of a 57-year-old woman. Results of mycological tests, carried out recently, were not always identical – on the first one Alternaria alternata was proved in the infected tissue, the second examination was negative. During the final one the presence of septate non-pigmentate hyphae in the tissue were detected by direct microscopy and Trichophyton rubrum and Alternaria alternata were growing mixed in the culture. Long duration of the disease (more than 20 years) and its frequent relapses are apparently an expression of well established synergism of the both pathogens. History of the patient indicates that the primary pathogen represented some of dermatophytes, while the non-dermatophyte mould Alternaria alternata invaded the infected tissue secondarily. In the discussion basic literature data concerning the occurrence, clinical course and etiology of an onychomycosis are summarized.

Key words:
onychomycosis – toenails – Alternaria alternata – Trichophyton rubrum – diagnostics – treatment