Uncommon Presentation of Onychomycosis Caused by Aspergillus niger in a Healthy Adult: A Case of Non-Dermatophyte Mold Infection
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By
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Sugat A. Jawade
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Nandkishor J. Bankar
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Sudhir P. Singh
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Sabiha T. Quazi
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Mayur S. Dudhe
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Rutwik Khandeshe
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January 22, 2026
Clinical Scorecard: Uncommon Presentation of Onychomycosis Caused by Aspergillus niger in a Healthy Adult: A Case of Non-Dermatophyte Mold Infection
At a Glance
| Category | Detail |
|---|
| Condition | Onychomycosis caused by Aspergillus niger |
| Key Mechanisms | Non-dermatophyte molds (NDMs) as primary pathogens |
| Target Population | Immunocompetent adults, particularly in tropical and subtropical climates |
| Care Setting | Dermatology outpatient department |
Key Highlights
- Onychomycosis accounts for 18-50% of nail disorders and 30% of cutaneous fungal infections.
- NDMs are increasingly recognized as significant etiologic agents of onychomycosis.
- Diagnosis requires clinical suspicion and confirmatory mycological investigations.
- Aspergillus niger can cause localized nail discoloration without systemic symptoms.
- Effective management includes oral terbinafine and topical ciclopirox.
Guideline-Based Recommendations
Diagnosis
- Use potassium hydroxide (KOH) mount, fungal culture, and histopathological examination for diagnosis.
Management
- Initiate oral terbinafine 250 mg daily for three months and topical ciclopirox 8% nail lacquer applied twice weekly.
Monitoring & Follow-up
- Follow-up at three and six months to assess treatment response and recurrence.
Risks
- Misdiagnosis due to atypical presentation of NDM infections.
Patient & Prescribing Data
Immunocompetent adults with localized onychomycosis.
Oral terbinafine and topical ciclopirox are effective in treating NDM-induced onychomycosis.
Clinical Best Practices
- Maintain nail hygiene and avoid prolonged exposure to moisture.
- Consider NDMs in differential diagnosis of onychomycosis, especially in humid climates.
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