Ann Dermatol.  2012 May;24(2):209-213.

Onychomycosis Caused by Scopulariopsis brevicaulis: Report of Two Cases

• Lee MH
• Hwang SM
• Suh MK
• Ha GY
• Kim H
• Park JY

Abstract

Onychomycosis is usually caused by dermatophytes, but some nondermatophytic molds and yeasts are also associated with invasion of nails. Scopulariopsis brevicaulis is a nondermatophytic mold found in soil as a saprophyte. We report two cases of onychomycosis caused by S. brevicaulis in a 48-year-old male and a 79-year-old female. The two patients presented with a typical distal and lateral subungual onychomycosis. Direct microscopic examination of the potassium hydroxide preparation revealed fungal elements. From toenail lesions of the patients, brown colonies with powdery surface, which are a characteristic of S. brevicaulis, were cultured on two Sabouraud's dextrose agar plates. Three cultures taken from nail plates within a 2-week interval yielded similar findings. Numerous branched conidiophores with chains of rough walled, lemon-shaped conidia were observed in slide culture by light microscopy and scanning electron microscopy. The nucleotide sequences of the internal transcribed spacer for the two clinical isolates were identical to that of S. brevicaulis strain WM 04.498. To date, a total of 13 cases of S. brevicaulis onychomycosis including the two present cases have been reported in Korea. Mean age of the patients was 46.1 years, with a higher prevalence in males (69.2%). Toenail involvement was observed in all cases including a case involving both fingernail and toenail. The most frequent clinical presentation was distal and lateral subungual onychomycosis in 12 cases, while one case was proximal subungual onychomycosis.

Keyword

Onychomycosis; Scopulariopsis brevicaulis

MeSH Terms

Agar
Aged
Arthrodermataceae
Base Sequence
Female
Fungi
Glucose
Humans
Hydroxides
Korea
Light
Male
Microscopy
Microscopy, Electron, Scanning
Middle Aged
Nails
Onychomycosis
Potassium
Potassium Compounds
Prevalence
Scopulariopsis
Soil
Spores, Fungal
Sprains and Strains
Yeasts
Agar
Glucose
Hydroxides
Potassium
Potassium Compounds
Soil

Figure

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  Fig. 1 (A) Brownish-yellow discoloration with hyperkeratosis on the toenails. (B) Close-up view of the right 2nd toenail.

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  Fig. 2 Brown colonies with powdery surface after incubation at 25℃ for 2 weeks. (A) Sabouraud's dextrose agar slant. (B) Sabouraud's dextrose agar plate.

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  Fig. 3 (A) Slide culture of Scopulariopsis brevicaulis showing numerous branched conidiophores with chains of lemon-shaped conidia (Lactophenol-cotton blue stain, ×400). (B) Numerous branched conidiophores with chains of lemon-shaped conidia (scanning electron microscop [SEM], ×1,500). (C) Lemon-shaped conidia with a rough walled feature (SEM, ×3,000).

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  Fig. 4 (Alignment of internal transcribed spacer 1 (ITS1) sequences of the Scopulariopsis brevicaulis isolates and Scopulariopsis brevicaulis strain WM 04.498 (GenBank accession number: AJ85377). The ITS1 sequences of clinical isolates exhibit a perfect match to that of the reference WM 04.498.

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