Onychomycosis due to saprophytic fungi

Twenty five cases of onychomycosis due to filamentous saprophytic agents were diagnosed within the period 1981–1982 in two mycology laboratories in Medellín, Colombia. These cases represented 4.5% and 9.5% respectively of the total fungal nail lesions (FNL) seen at those institutions. No explanation was found for the high frequencies, which sharply contrast with the previous local experience with the disease (0.4% of FNL). The responsible agents belonged to the following genera in decreasing order of frequency: Fusarium, Aspergillus, Scopulariopsis, Penicillium and Lasiodiplodia; two patients were infected with unidentified dematiaceous fungi and two more had the association of a saprophyte and a dermatophyte. In every case direct KOH preparations revealed septate hyphae, associated in 14 patients (56%) with chlamydoconidia. The only predisposing factors that were common to all these patients were age above 20 years and the use of footwear.