{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T09:47:15Z","timestamp":1761126435263,"version":"3.40.4"},"reference-count":15,"publisher":"S. Karger AG","issue":"2","license":[{"start":{"date-parts":[[2004,1,1]],"date-time":"2004-01-01T00:00:00Z","timestamp":1072915200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2004,1,1]],"date-time":"2004-01-01T00:00:00Z","timestamp":1072915200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dermatology"],"published-print":{"date-parts":[[2004]]},"abstract":"<i>Background:<\/i> Non-dermatophytic onychomycoses represent 1.45\u201317.6% of all fungal nail infections. Epidemiological studies have shown that <i>Aspergillus<\/i> spp. are emerging fungal agents of toenail onychomycosis. Indeed, after <i>Scopulariopsis<\/i> spp. the genus <i>Aspergillus<\/i> is the second most common agent of non-dermatophytic onychomycosis. The diagnosis and treatment of toenail onychomycosis caused by non-dermatophyte moulds are not always straightforward. <i>Objectives:<\/i> The aims of this study were to describe the clinical appearance of toenail onychomycosis due to <i>Aspergillus<\/i> spp., to investigate the pathogenetic role of these agents and to evaluate the efficacy and safety of weekly intermittent terbinafine (500 mg\/day for 1 week each month for 3 months) in the treatment of these patients. <i>Patients and Methods:<\/i> Mycological study of 2,154 patients with onychodystrophy revealed 1,228 onychomycoses (57%) including 71 cases due to non-dermatophytic fungi (5.6%). Non-dermatophytic onychomycosis caused by <i>Aspergillus<\/i> spp. represented 2.6% of all onychomycoses. The subjects were 34 patients (22 females, 12 males, age range 30\u201382 years) observed between September 1999 and December 2001, with toenail onychomycosis caused by <i>Aspergillus<\/i> spp. confirmed by standard techniques (microscopic examination and culture according to the criteria of English), histological examination of nail clippings and scanning electron microscope examination of the cultures whenever necessary. <i>Results:<\/i> The clinical features suggesting onychomycosis due to <i>Aspergillus<\/i> spp. are chalky deep white nail, rapid involvement of lamina and painful perionyxis without pus. Standard mycological tests (direct microscopy and fungal culture) and histological examination confirmed the pathogenetic role of <i>Aspergillus<\/i> spp. in onychomycoses. In particular, the histological examination was positive in 28 cases (82%) and useful in identifying typical aspects of <i>Aspergillus<\/i> spp. nail infections. At the follow-up, 12 months after the start of therapy with pulsed terbinafine, clinical and mycological recovery was confirmed in 30 of the 34 patients (88%). <i>Conclusions:<\/i> Treatment of non-dermatophytic onychomycosis with terbinafine usually requires at least 3 months of continuous systemic therapy. Our study of 34 patients confirms that terbinafine is particularly effective in the treatment of <i>Aspergillus<\/i> spp. nail infections and that a pulsed regimen is more economical and less demanding.<\/jats:p>","DOI":"10.1159\/000079593","type":"journal-article","created":{"date-parts":[[2004,8,23]],"date-time":"2004-08-23T08:31:08Z","timestamp":1093249868000},"page":"104-110","source":"Crossref","is-referenced-by-count":45,"title":["Clinical and Histological Aspects of Toenail Onychomycosis Caused by <i>Aspergillus<\/i> spp.: 34\u00a0Cases Treated with Weekly Intermittent Terbinafine"],"prefix":"10.1159","volume":"209","author":[{"given":"Claudia","family":"Gianni","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clara","family":"Romano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2004,8,19]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1439-0507.2000.00547.x"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1159\/000051631"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1159\/000051836"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1159\/000051643"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1159\/000073086"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.45.6.1882-1885.2001"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1046\/j.1439-0507.2003.00812.x"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1046\/j.1439-0507.2001.00670.x"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1023\/A:1007044720147"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1159\/000051659"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1007\/s102270000019"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1159\/000051618"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1067\/mjd.2001.110644"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2133.2001.04144.x"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-4362.2002.01672.x"}],"container-title":["Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/79593","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/79593","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T03:26:20Z","timestamp":1745465180000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000079593"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004]]},"references-count":15,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2004,8,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000079593","archive":["Portico"],"relation":{},"ISSN":["1018-8665","1421-9832"],"issn-type":[{"type":"print","value":"1018-8665"},{"type":"electronic","value":"1421-9832"}],"subject":[],"published":{"date-parts":[[2004]]}}}