{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T12:31:15Z","timestamp":1790685075338,"version":"4.1.0"},"reference-count":23,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2015,7,29]],"date-time":"2015-07-29T00:00:00Z","timestamp":1438128000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"published-print":{"date-parts":[[2015,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Invasive fusariosis is an infection with <jats:italic>Fusarium<\/jats:italic> spp. that primarily affects patients with hematologic malignancies and hematopoietic cell transplant recipients. Wounds, digital ulcers, onychomycosis, and paronychia are the typical cutaneous portals of entry. Early management of mycotic nails in immunocompromised and diabetic hosts is crucial to prevent life\u2010threatening disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We report nine cases of <jats:italic>Fusarium<\/jats:italic> onychomycosis (<jats:italic>F.\u00a0dimerum<\/jats:italic>,<jats:italic> n<\/jats:italic>\u00a0=\u00a05; <jats:italic>F.\u00a0oxysporum<\/jats:italic>,<jats:italic> n<\/jats:italic>\u00a0=\u00a03; <jats:italic>Fusarium<\/jats:italic> spp., <jats:italic>n<\/jats:italic>\u00a0=\u00a01) in immunocompetent hosts and their response to itraconazole and terbinafine pulse therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The patients received either itraconazole 400\u00a0mg daily or terbinafine 500\u00a0mg daily for 7\u00a0d\/month; two pulses for fingernails and three pulses for toenails.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 68 confirmed cases of onychomycosis, eight (11.7%) were <jats:italic>Fusarium<\/jats:italic> spp.; the ninth patient was culture positive but microscopy negative and responded well to itraconazole. Distal subungual onychomycosis was the commonest clinical manifestation (seven of nine), one had proximal subungual onychomycosis, and total onychodystrophy was noted on four patients. Associated paronychia was marked on 66.7% (six of eight) patients. Itraconazole was given to six patients\/25 nails and terbinafine to three patients\/20 nails. All nine patients completed treatments, but one defaulted at 12\u00a0months follow\u2010up. The efficacy parameters were clinical cure (<jats:styled-content style=\"fixed-case\">CC<\/jats:styled-content>) and mycological cure (<jats:styled-content style=\"fixed-case\">MC<\/jats:styled-content>). At month 12 after the start of treatment, the response was itraconazole <jats:styled-content style=\"fixed-case\">CC<\/jats:styled-content> 13 of 25 (52%)\/<jats:styled-content style=\"fixed-case\">MC<\/jats:styled-content> four of six (66.6%) and terbinafine <jats:styled-content style=\"fixed-case\">CC<\/jats:styled-content> four of eight (50%)\/<jats:styled-content style=\"fixed-case\">MC<\/jats:styled-content> one of two (50%). Recurrence was noted in four of 13 (30.7%) and eight of 13 (61.5%) cured nails in the itraconazole group within 3 and 12\u00a0months, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:italic>Fusarium<\/jats:italic> onychomycosis was clinically indistinguishable from other onychomycosis. Both itraconazole and terbinafine pulse therapy were only partially effective on <jats:italic>Fusarium<\/jats:italic> onychomycosis. Antifungals that are more effective should be sought.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ijd.12906","type":"journal-article","created":{"date-parts":[[2015,7,29]],"date-time":"2015-07-29T21:44:53Z","timestamp":1438206293000},"page":"1275-1282","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["<i>Fusarium<\/i> onychomycosis: prevalence, clinical presentations, response to itraconazole and terbinafine pulse therapy, and 1\u2010year follow\u2010up in nine cases"],"prefix":"10.1111","volume":"54","author":[{"given":"Ranthilaka R.","family":"Ranawaka","sequence":"first","affiliation":[{"name":"Department of Dermatology Base Hospital Homagama Galle Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajith","family":"Nagahawatte","sequence":"additional","affiliation":[{"name":"Department of Microbiology Faculty of Medicine University of Ruhuna Galle Sri 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