ONYCHOMYCOSIS DUE TO SCOPULARIOPSIS-BREVICAULIS - CLINICAL-FEATURES AND RESPONSE TO SYSTEMIC ANTIFUNGALS

Six cases of Scopulariopsis onychomycosis, including four patients wit h onychomycosis exclusively caused by Scopulariopsis brevicaulis and t wo patients with a mixed nail infection (S. brevicaulis + Tricophyton rubrum and S. brevicaulis + T. interdigitale), are reported. Four pati ents presented with a typical distal subungual onychomycosis character ized by subungual hyperkeratosis and onycholysis of the distal nail pl ate. In two patients, Scopulariopsis infection produced a total dystro phic onychomycosis associated with painful periungual inflammation, Th ree patients were treated with four pulses of itraconazole, 400 mg dai ly for 1 week a month, and three patients with terbinafine, 250 mg dai ly for 4 months. The mycological examination 8 months after discontinu ation of treatment showed that one patient was mycologically cured whe reas the remaining five patients still carried S. brevicaulis in their nails, The clinical examination at the end of the follow-up period sh owed a complete cure of the nail abnormalities in only one patient.