Department of Dermatology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Dermatology. 2010;220(2):164-8. doi: 10.1159/000277762. Epub 2010 Jan 29.
Dermatophytes are the main cause of onychomycoses, but various non-dermatophyte filamentous fungi are often isolated from abnormal nails.
Our aim was the in situ identification of the fungal infectious agent in 8 cases of onychomycoses which could not be cured after systemic terbinafine and itraconazole treatment.
Fungal DNA was extracted from nail samples, and infectious fungi were identified by restriction fragment length polymorphism (RFLP) of amplified fungal ribosomal DNA using a previously described PCR/RFLP assay.
PCR/RFLP identification of fungi in nails allows the identification of the infectious agent: Fusarium sp., Acremonium sp. and Aspergillus sp. were found as a sole infectious agent in 5, 2 and 1 cases, respectively.
Fusarium spp. and other non-dermatophyte filamentous fungi are especially difficult to cure in onychomycoses utilising standard treatment with terbinafine and itraconazole. PCR fungal identification helps demonstrate the presence of moulds in order to prescribe alternative antifungal treatments.
皮肤癣菌是甲真菌病的主要病因，但各种非皮肤癣菌丝状真菌常从异常指甲中分离出来。
我们的目的是对 8 例经特比萘芬和伊曲康唑全身治疗后仍未治愈的甲真菌病患者的指甲样本中的真菌进行原位鉴定。
从指甲样本中提取真菌 DNA，并用先前描述的 PCR/RFLP 方法扩增核糖体 DNA 的限制性片段长度多态性（RFLP）来鉴定传染性真菌。
PCR/RFLP 鉴定指甲中的真菌可鉴定病原体：5 例、2 例和 1 例分别为镰孢菌属、枝孢霉属和曲霉属为单一病原体。
在使用特比萘芬和伊曲康唑进行标准治疗的情况下，甲真菌病中镰刀菌属和其他非皮肤癣菌丝状真菌尤其难以治愈。PCR 真菌鉴定有助于证明霉菌的存在，从而开具替代抗真菌治疗药物。
