エフィナコナゾール爪外用液で治療したFusarium oxysporumによる爪無色菌糸症

・近位爪甲下型の病型を呈する非白癬性爪真菌症を経験した．

・非白癬性爪真菌症の診断基準を満たし，分離菌の形態学的特徴と遺伝子検査によりFusarium oxysporum（F. oxysporum）による爪無色菌糸症と診断した．

・エフィナコナゾール爪外用液による治療で治癒した．

・わが国の1964年以降のフサリウム属による爪無色菌糸症17例を集計した．

（「症例のポイント」より）

　

Ungual hyalohyphomycosis caused by Fusarium oxysporum successfully treated with topical efinaconazole

　

Hirose, Miki1）Noguchi, Hiromitsu2）Matsumoto, Tadahiko2）Hiruma, Masataro3）Yaguchi, Takashi4）Sato, Takahiro1） 1）Department of Dermatology, National Defense Medical College 2）Noguchi Dermatology Clinic 3）‌Ochanomizu Institute for Medical Mycology and Allergology and Division of Bio-resources, Medical Mycology Research Center 4）Medical Mycology Research Center, Chiba University

　

A 45-year-old male construction worker presented with a whitish discoloration at the base of the left big toenail and painful paronychia. He had borderline diabetes. Direct microscopy of nail specimen revealed chlamydoconidia and hyphae. Periodic acid-Schiff staining showed septate hyphae. Based on these morphological features and gene analysis, we diagnosed him as ungual hyalohyphomycosis caused by Fusarium oxysporum and ruled out contamination in accordance with Guputa’s criteria for non-dermatophyte mould onychomycosis. The minimum inhibitory concentrations were ＞16μg/ml for terbinafine, ＞16μg/ml for itraconazole, 0.5μg/ml for efinaconazole. Treatment with 10％ efinaconazole solution cured the disease in 6 months.