Onychomycosis Due to <Emphasis Type="Italic">Aspergillus</Emphasis> spp.: a Current Review

Purpose of Review

The incidence of onychomycosis by Aspergillus has shown an increase in recent years, representing 34–60% of onychomycosis due to non-dermatophyte molds. At least 26 species of Aspergillus causing onychomycosis have been reported, some of which may be morphologically indistinguishable but genetically distinct, even in their susceptibility profile to antifungals. So in the diagnosis of this pathology, it is necessary to use both conventional and molecular methods to get to the identification of the fungus at the species level and thus establish the appropriate treatment.

Recent Findings

The current taxonomy of the genus Aspergillus includes sections that are made up of species whose morphology is almost identical but have different patterns of susceptibility to antifungals. Advances in the taxonomy of these fungi reveal the need to combine phenotypic methods (analysis of microscopic and macroscopic characteristics) with molecular ones (amplification and sequencing of fragments of the β-tubulin and calmodulin genes) to achieve their correct identification at the level of species.

Summary

From the demonstration of Aspergillus as the primary agent of onychomycosis, an increase in the incidence of this pathology worldwide has been reported, whose treatment is usually complicated. Various species of Aspergillus can cause nail infection but may respond differently to antifungal treatment, so it is important to know their epidemiology, clinical characteristics, etiologic agents, diagnostic methods, and treatment.