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In studies where the ongoing invasive presence of NDMs is confirmed through repeat cultures, the global prevalence of NDMs in onychomycosis patients is estimated at 6.9% with the 3 most common genus being: <jats:italic>Aspergillus<\/jats:italic>, <jats:italic>Scopulariopsis<\/jats:italic> and <jats:italic>Fusarium<\/jats:italic>. NDM onychomycosis can, in many cases, appear clinically indistinguishable from dermatophyte onychomycosis. Clinical features suggestive of NDMs include proximal subungual onychomycosis with paronychia associated with <jats:italic>Aspergillus<\/jats:italic> spp., <jats:italic>Fusarium<\/jats:italic> spp. and <jats:italic>Scopulariopsis brevicaulis<\/jats:italic>, as well as superficial white onychomycosis in a deep and diffused pattern associated with <jats:italic>Aspergillus<\/jats:italic> and <jats:italic>Fusarium<\/jats:italic>. Longitudinal streaks seen in patients with distal and lateral onychomycosis may serve as an additional indicator. For diagnosis, light microscopic examination should demonstrate fungal filaments consistent with an NDM with at least two independent isolations in the absence of a dermatophyte; the advent of molecular testing combined with histological assessment may serve as an alternative with improved sensitivity and turnover time. In most instances, antifungal susceptibility testing has limited value. Information on effective treatments for NDM onychomycosis is relatively scarce, unlike the situation in the study of dermatophyte onychomycosis. Terbinafine and itraconazole therapy (continuous and pulsed) appear effective to varying extents for treating onychomycosis caused by <jats:italic>Aspergillus<\/jats:italic>, <jats:italic>Fusarium<\/jats:italic> or <jats:italic>Scopulariopsis<\/jats:italic>. There is scant literature on oral treatments for <jats:italic>Neoscytalidium<\/jats:italic>.<\/jats:p>","DOI":"10.1111\/jdv.19644","type":"journal-article","created":{"date-parts":[[2023,11,28]],"date-time":"2023-11-28T00:37:54Z","timestamp":1701131874000},"page":"480-495","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["A comprehensive review of nondermatophyte mould onychomycosis: Epidemiology, diagnosis and management"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8664-7723","authenticated-orcid":false,"given":"Aditya K.","family":"Gupta","sequence":"first","affiliation":[{"name":"Division of Dermatology, Department of Medicine University of Toronto  Toronto Ontario Canada"},{"name":"Mediprobe Research Inc.  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