Uncommon Presentation of Onychomycosis Caused by Aspergillus niger in a Healthy Adult: A Case of Non-Dermatophyte Mold Infection
By
Sugat A. Jawade
Nandkishor J. Bankar
Sudhir P. Singh
Sabiha T. Quazi
Mayur S. Dudhe
Rutwik Khandeshe
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. References
