Non-Dermatophyte Onychomycosis Caused by Aspergillus in a Patient with Systemic Lupus Erythematosus: A Case Report

Authors

  • Devi Dwi Sintia Department of Dermatology and Venereology, Dr. Soetomo General Hospital, Surabaya, Indonesia
  • Menul Ayu Umborowati Department of Dermatology and Venereology, Dr. Soetomo General Hospital, Surabaya, Indonesia
  • Sunarso Suyoso Department of Dermatology and Venereology, Dr. Soetomo General Hospital, Surabaya, Indonesia
  • Evy Ervianti Department of Dermatology and Venereology, Dr. Soetomo General Hospital, Surabaya, Indonesia
  • Linda Astari Department of Dermatology and Venereology, Dr. Soetomo General Hospital, Surabaya, Indonesia
  • Hasnikmah Mappamasing Department of Dermatology and Venereology, Dr. Soetomo General Hospital, Surabaya, Indonesia
  • Trisiswati Indranarum Department of Dermatology and Venereology, Dr. Soetomo General Hospital, Surabaya, Indonesia
  • Yuri Widia Dermatology and Venereology Airlangga University a:1:{s:5:"en_US";s:0:"";}

Keywords:

Non dermatophyte onychomycosis, Aspergillus onychomycosis, Systemic Lupus Erythematosus, Itraconazole

Abstract

Onychomycosis is a fungal infection of nails, occasionally found on fingernails. Non-dermatophytes molds (NMDs), such as Aspergillus spp., are increasingly reported, particularly in immunocompromised patients. We report a case of a 19-year-old female with systemic lupus erythematosus (SLE), treated with immunosuppressive drugs, presenting with proximal subungual onychomycosis. Fungal cultures confirmed Aspergillus flavus. The patient achieved complete clinical and mycological cure after three months of pulsed oral itraconazole therapy. This case emphasizes the need for proper mycological diagnosis in immunocompromised patients presenting with nail abnormalities.

References

Maskan Bermudez N, Rodríguez-Tamez G, Perez S, Tosti A. Onychomycosis: Old and New. J Fungi (Basel). 2023 ;9(5):559. Doi: 10.3390/jof9050559.

Widaty S, Oktarina C, Marissa M, Adawiyah R, Rozaliyani A, Kartika E, et al. Clinical and microbi-ological characteristics of onychomycosis in a ter-tiary hospital: a cross-sectional study. Med J In-dones. 2024;33(1):17-23. Doi: org/10.13181/mji.oa.247201

Bongomin F, Batac CR, Richardson MD, Denning DW. A review of onychomycosis due to Aspergillus species. Mycopathologia. 2018;183(3):485-493. Doi: 10.1007/s11046-017-0222-9..

Gnat S, Łagowski D, Nowakiewicz A, Dylag M. A global view on fungal infections in humans and animals: opportunistic infections and microsporid-ioses. J Appl Microbiol. 2021 Nov;131(5):2095-2113. Doi: 10.1111/jam.15032.

Sudipa PH, Puja IK, Dharmayuda AAGO, Gun-awan IWNF, Sudimartini LM, Jayanti PD, et al. Identification and Prevalence of Aspergillus sp Iso-lated from Bali Dog’s Skin. J. Riset Vet. Ind; 7(1).doi.org/10.20956/jrvi.v7i1.21594.

Craddock LN, Schieke SM. Superficial Fungal Inf-ection. In: Kang S, Amagai M, Bruckner AL, Enk AH, Margolis DJ, McMichael AJ, et al., editors. Fit-zpatrick’s Dermatology. 9th ed. New York: Mc-Graw-Hill Education; 2019. p. 2925–2951.

Leung AKC, Lam JM, Leong KF, Hon KL, Barankin B, Leung AAM, et al. Onychomycosis: An

updated review. Recent Pat Inflamm Allergy Drug Discov 2020;14(1):32-45.

Doi: 10.2174/1872213X13666191026090713.

Gupta AK, Summerbell RC, Venkataraman M, Quinlan EM. Non-dermatophyte mould onycho-mycosis. J Eur Acad Dermatol Venereol. 2021;35(8):1628-1641. Doi: 10.1111/jdv.17240.

Walsh TH, Hayden RT, Larone DH. Larone’s medi-cally important fungi- a guide to identification. 6th ed. Washington: ASM Press; 2018. Doi: 10.1128/9781555819880.

Pal M, Dave P, Dave K, Gutama K, Thangavelu L, Paula C, et al. Etiology, clinical spectrum, epidemi-ology, new developments in diagnosis and the-rapeutic management of onychomycosis: an update. Am J Microbiol Res. 2023;11:19–24.

Downloads

Published

2025-09-30

How to Cite

1.
Devi Dwi Sintia, Menul Ayu Umborowati, Sunarso Suyoso, Evy Ervianti, Linda Astari, Hasnikmah Mappamasing, Trisiswati Indranarum, Widia Y. Non-Dermatophyte Onychomycosis Caused by Aspergillus in a Patient with Systemic Lupus Erythematosus: A Case Report. J Pak Assoc Dermatol [Internet]. 2025Sep.30 [cited 2025Nov.25];35(3):264-7. Available from: https://jpad.com.pk/index.php/jpad/article/view/2945

Issue

Section

Case Reports

Most read articles by the same author(s)