Dermatophyte Infections Research Articles

Otomycosis Caused by Trichophyton mentagrophytes: About Two Cases

Otomycosis is a common superficial fungal infection that affects the external auditory canal. The infection may present as acute, subacute, or chronic, and is typically unilateral, the species causing fungal infection in the ear include molds, yeasts. Members of the dermatophytes, normally seen from infected skin and nails, have seldom been implicated in otomycosis. Both patients had presented with unilateral ear pain and reduced hearing. on examination of a swab, secretions bearing fungal filaments of dermatophyte elements. Culture yielded Trichophyton mentagrophytes. The dermatophytic infection of the ear is a rare condition whose symptoms are not specific and their diagnosis requiring a careful sampling and mycological examination.

Predominance of Trichophyton soudanense as Agent of Dermatophytoses in Cape Verdean School-Age Children.

Dermatophytoses are infectious skin diseases of public health importance because of their transmissibility and high prevalence, especially among children. This is the first study aiming to estimate and report the burden of dermatophytoses on school-age children on the island of Santiago in Cape Verde, an African country that is an archipelago. A total of 249 students attending the afternoon shift of three elementary schools in the city of Achada Igreja were examined. Of these, 60 had suspected lesions of dermatophyte infection. However, from the samples collected from these 60 students, including hair, nails, and skin scrapings, only 18 dermatophyte isolates were obtained, corresponding to a point prevalence of 7.2%. Morphological species identification demonstrated three different species: Trichophyton soudanense, Trichophyton rubrum, and Trichophyton violaceum; re-identification by sequencing the internal transcribed spacer (ITS) 1 and 2 regions of ribosomal DNA, and the 5.8S rDNA encoding gene (ITS-5.8S region), revealed T. soudanense as the most prevalent species, with only one case of T. rubrum. This is the first epidemiological data describing dermatophytoses and dermatophytes in Cape Verde among school-age children on one of the archipelago islands. It reinforces the need of using culture and accurate identification methodologies when gathering epidemiological data on dermatophytoses.

Superficial fungal infections in adults in Northern Finland between 2010 and 2021: A register-based study.

Superficial fungal infections are common dermatological reasons to visit a doctor in primary care in Finland. However, their variable clinical picture and minor symptoms may lead to delayed diagnosis. We aimed to investigate the epidemiology and patient profile of fungal infections treated in secondary care over a decade. This is a retrospective study including adult patients with a fungal infection in the scalp, nails, or superficial skin diagnosed at the Oulu University Hospital, Finland between the years 2010 and 2021. There were 573 patients with male predominance (57.6%). All studied fungal infections were more common in the oldest age group (>61 years). The number of fungal infections increased from the year 2017 onward. Only one-third (37.7%) of the patients were referred to the dermatology clinic because of a suspected dermatophyte infection, and in 46.0% of cases, the diagnostic delay exceeded 6 months. The most common fungal infection was tinea pedis (n = 295, 51.5%) followed by tinea unguium (n = 275, 48.0%); as concomitant infection, they were present in 108 (18.8%) of all patients. The most common pathogen causing a fungal infection was Trichophyton rubrum. During the study period, the incidence of diagnosed superficial fungal skin infections increased. There was a remarkable diagnostic delay from the onset of symptoms to diagnosis in these most common dermatological conditions.

Dermatologic Conditions in Down Syndrome: A Multi-Site Retrospective Review of International Classification of Diseases Codes.

As the population and life expectancy of people with Down syndrome increases, identifying common skin conditions throughout the lifespan will help inform clinical care and research. We sought to evaluate dermatologic conditions diagnosed in pediatric and adult patients with Down syndrome. This multicenter retrospective study analyzed demographic and outpatient visit International Classification of Diseases codes of patients with Down syndrome evaluated at outpatient dermatology clinics in the United States or Canada between 2011 and 2021. A total of 1529 patients with Down syndrome were identified from eight academic medical centers: 50.8% were children (0-12 years), 25.2% were adolescents (13-17 years), and 24% were adults (18 years and older). Eczematous dermatitis was the most common diagnosis overall (26%), followed by folliculitis (19.3%) and seborrheic dermatitis (15.6%). Other notable diagnoses included dermatophyte infections (13%), alopecia areata (11.6%), and psoriasis (6.7%). About 4.3% of visits included a code for high-risk medication use. Eczematous dermatitis, alopecia areata, and folliculitis were the most common diagnoses observed in children; folliculitis, hidradenitis suppurativa, and eczematous dermatitis in adolescents; and seborrheic dermatitis, eczematous dermatitis, and folliculitis in adults. Dermatologic conditions in patients with Down syndrome vary by age, but are most often eczematous, adnexal, and cutaneous autoimmune disorders. This multicenter retrospective review identifies skin diseases that should be prioritized for clinical care guideline development and research in the Down syndrome community.

Isolation and Diagnosis of Dermatophytes of the Hand Tinea and Sensitivity Study to the Antifungals Griseofulvin

The study was conducted during the month of October 2022 until April 2023, with the aim of isolating and diagnosing the fungi that cause skin diseases from patients visiting the dermatology consultation affiliated with Salah al-Din General Hospital who were diagnosed as infected by dermatologists for the period from 1/6/2022 to 1/ 12/2023 For both sexes, aged between 10 and 60 years, by taking skin samples from the area of infection after wiping them with cotton saturated with 70% alcohol for the purpose of sterilization to get rid of any contaminants. Which was diagnosed clinically by a dermatologist in the dermatology consultation at Salah al-Din General Hospital and outpatient clinics. To evaluate the effectiveness of anti-griseofulvin in inhibiting the isolated fungi, the percentage of dermatophyte infections recorded by positive direct microscopic examination was only (88) patients, representing (88%) of the total number of patients. While the number of negative cases by negative direct microscopic examination was (59), or (59%). As for positive laboratory culture results, there were (79) patients, in the rate of (79%). While the number of negative cases by laboratory culture was (21), in the rate of (21%). The fungal genera that cause skin infections, such as Trychophyton and Microsporum, were isolated, with the genus Trichophyton being the most frequent, with 76 isolates belonging to several species, such as T. mentagrophytes, with a number of 29 isolates, then the fungus T. rubrum, with a number of isolates of 22, then the fungus T. terreste, with a number of isolates of 15, and then fungus T. schoenleinii, with a number of 10 isolates, while only three isolates of the M. canis type were recorded in the genus Microsporum. The results of the susceptibility test of the isolated fungi to Griseofulvin showed that the fungus T. mentagrophytes is more sensitive to the antichrysofulvin, as the average diameter of inhibition reached 32 mm compared to the control, followed by T. rubrum, which had an average diameter of inhibition of 16 mm compared to the control.

Possible Terbinafine and/or Itraconazole Induced Vasculitis - A Case Study

Introduction: It is essential to exclude other causes, such as autoimmune diseases and bacterial infections, before attributing cutaneous/systemic vasculitis to drug use. Case Study: This report discusses the case of a young man who developed multi-organ failure and cutaneous vasculitis following the use of antifungal medications (terbinafine and itraconazole) for dermatophyte infections. Tests for autoimmune diseases and infections were negative. Given his drug history and a skin biopsy indicating leukocytoclastic vasculitis, it was inferred that the vasculitis was likely drug-induced. Despite treatment with steroids, intravenous immunoglobulins, and plasmapheresis, the patient did not survive, possibly due to delayed diagnosis and treatment. Conclusion: In community practice, Drug-induced Vasculitis (DIV) is frequently overlooked. When patients present with skin rash, fever, and multi-organ dysfunction, DIV should be considered, particularly in the context of recent drug use. Over-the-counter antifungals, like terbinafine or itraconazole, can cause DIV and may be fatal if not promptly diagnosed and treated.

PCR enables rapid detection of dermatophytes in practice.

Dermatophytes cause superficial infections of skin, hair, and nails. Even though they rarely cause severe infections, they are relatively common, particularly in primary health care. Diagnosis of dermatophyte infections has relied on relatively slow culture-based methods. Nucleic acid-based detection (PCR) methods might provide results more rapidly. Here, we describe the transition from culture-based methods into PCR-based methods in Northern Finland with a catchment area of approximately 720,000 mostly Caucasian people. This study included 14,330 samples collected between 2019 and 2022. Our results showed that the PCR-based method has become the diagnostic test of choice for these infections in this area. Commercial real-time PCR assay DermaGenius 2.0 complete multiplex test detected more positive results than culture and covered the most important dermatophytes, Candida albicans, and few less common species. With PCR, the mean turn-around-time from sample request to results decreased from 19 days to 16 hours.IMPORTANCESuperficial fungal infections, dermatophytosis, are remarkably common worldwide, affecting an estimated 20%-25% of the global population. In the diagnosis of these infections, fast and accurate results by PCR shorten the time to diagnosis and help clinicians to avoid unnecessary antifungal treatments.

Chinese expert consensus on management of antifungal-resistant dermatophytoses (2024 edition).

Antifungal-resistant dermatophytes (ARD) infection is a hotspot issue in clinical microbiology and the dermatology field. Trichophyton indotineae as the dominant species of dermatophyte with terbinafine-resistance or multidrug resistance, is easy to be missed detection clinically, which brings severe challenges to diagnosis and treatment. ARD infection cases have emerged in China, and it predicts a risk of transmission among human. Based on the existing medical evidence and research data, the Mycology Group of Combination of Traditional and Western Medicine Dermatology and Chinese Antifungal⁃Resistant Dermatophytoses Expert Consensus Group organized experts to make consensus on the management of the infection. Here, the consensus formulated diagnosis and treatment recommendations, to raise attention to dermatophytes drug resistance problem, and expect to provide reference information for the clinical diagnosis, treatment, prevention and control.

New Sources of Resistance to Terbinafine Revealed and Squalene Epoxidase Modelled in the Dermatophyte Fungus Trichophyton interdigitale From Australia

ABSTRACTBackgroundTerbinafine is widely used to treat onychomycosis caused by dermatophyte fungi. Terbinafine resistance in recent years is causing concern. Resistance has so far been associated with single‐nucleotide substitutions in the DNA sequence of the enzyme squalene epoxidase (SQLE) but how this affects SQLE functionality is not understood.ObjectivesThe aim of this study was to understand newly discovered resistance in two Australian strains of Trichophyton interdigitale.Patients/MethodsResistance to terbinafine was tested in four newly isolated strains. Three‐dimensional SQLE models were prepared to investigate how the structure of their SQLE affected the binding of terbinafine.ResultsThis study found the first Australian occurrences of terbinafine resistance in two T. interdigitale strains. Both strains had novel deletion mutations in erg1 and frameshifts during translation. Three‐dimensional models had smaller SQLE proteins and open reading frames as well as fewer C‐terminal α‐helices than susceptible strains. In susceptible strains, the lipophilic tail of terbinafine was predicted to dock stably into a hydrophobic pocket in SQLE lined by over 20 hydrophobic amino acids. In resistant strains, molecular dynamics simulations showed that terbinafine docking was unstable and so terbinafine did not block squalene metabolism and ultimately ergosterol production. The resistant reference strain ATCC MYA‐4438 T. rubrum showed a single erg1 mutation that resulted in frameshift during translation, leading to C‐terminal helix deletion.ConclusionsModelling their effects on their SQLE proteins will aid in the design of potential new treatments for these novel resistant strains, which pose clinical problems in treating dermatophyte infections with terbinafine.

Knowledge, prevalence and prevention of dermatophyte infections among primary school pupils in Uyo Metropolis

Knowledge, prevalence and prevention of dermatophyte infections among primary school pupils in Uyo Metropolis

Skin health of Aboriginal children living in urban communities.

Skin concerns are frequent among urban-living Aboriginal children, yet specialist dermatology consultations are limited with studies highlighting the need for improved cultural security. Through newly established paediatric dermatology clinics at two urban Aboriginal Community Controlled Health Organisations (ACCHOs), we aimed to describe clinic and patient data, including disease frequencies and associations, to inform dermatology service provision and advocacy. A prospective cohort study of Aboriginal children and young people (CYP, 0-18 years) attending Aboriginal Health Practitioner (AHP) co-ordinated paediatric dermatology clinics at two urban ACCHOs. Data were collected from 32 clinics over 19 months, with 335 episodes of care and a mean attendance rate of 74%. From 78 new patients, 72 (92%) were recruited into the study, only one of whom had previously received dermatologist assessment. Eczema, tinea or acne accounted for 47% (34/72) of referrals, and 60% of patients received their first appointment within 4 weeks of referral. In 47/72 (65%) consultations, the GP referral and dermatologist diagnosis concurred. The most frequent diagnoses (primary or secondary) at first consultation were atopic dermatitis (26%, 19/72), dermatophyte infections (25%, 18/72), acne (21%, 15/72), bacterial skin infections (18%, 13/72) and post-inflammatory dyspigmentation (18%, 13/72). Three categories of the 2022 Australasian College of Dermatologists curriculum (infections, eczema/dermatitis, pigmentary disorders) accounted for 59% of all diagnoses. This study highlights the specialist dermatology needs of urban-living Aboriginal CYP. ACCHO-embedded dermatology clinics co-ordinated by AHPs demonstrated benefits for Aboriginal CYP in accessing care. Opportunities to embed dermatology practice within ACCHOs should be prioritised.

Synergistic potential of essential oil combinations against Microsporum, Trichophyton, and Epidermophyton.

Dermatophyte infections globally account for 20 to 25% of fungal infections. Dermatophytes have begun exhibiting antifungal drug resistance, making it challenging to treat this particular infection. Essential oils could be used as alternative solutions as they have been used for a long period to treat different infections. The research has demonstrated the antifungal efficacy of cinnamon, clove, lemongrass, tea tree, thyme, and garlic essential oils, and the impact of their combinations was assayed against Microsporum canis, Trichophyton tonsurans, T. violaceum, T. verrucosum, and Epidermophyton floccosum. Polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) was used to identify the most prevalent M. canis. The accession number of M. canis was obtained as ON007275. All tested essential oils exhibited antidermatophytic action except garlic. A synergistic effect was attained by cinnamon + clove, cinnamon + lemongrass, clove + lemongrass, clove + tea tree, and thyme + tea tree combinations. Concerning antifungal activity, M. canis was the most susceptible dermatophytic species, except in the case of thyme T. violaceum, which was the most susceptible dermatophytic species. The maximum inhibition was recorded in the cases of cinnamon and cinnamon + lemongrass combination against M. canis. The least minimum inhibitory concentrations were attained by cinnamon and clove against M. canis, cinnamon + clove against M. canis and T. violaceum, and cinnamon + lemongrass against M. canis, T. violaceum, T. verrucosum, and E. floccosum. The least minimum fungicidal concentration showed by cinnamon against M. canis, cinnamon + clove against M. canis and T. violaceum, cinnamon + lemongrass against M. canis, T. violaceum, T. verrucosum, and E. floccosum, and clove + lemongrass against M. canis.

Synergistic Anti-Dermatophytic Potential of Nanoparticles and Essential Oils Combinations

AbstractConventional antifungal therapies becoming less effective in treating dermatophytic infections. For this reason, researchers are looking for alternative treatments. The current research has tested the antifungal efficacy of eight novel synthesized metallic nanoparticle compounds: Ag0.49Cr2.51O4, Ag0.99Fe1.01O3, CoLa0.019Fe1.981O4, Co0.99Fe1.99O4, Ag0.99Cr1.01O2, Ca0.99Fe1.99O4, CoBi0.019Fe1.981O4, and Cu0.99Fe1.99O4 were synthesized by a flash auto-combustion reaction to evaluate synergistic potential of the Np’s exhibited antifungal activity in combination with Cinnamon, clove, lemongrass, tea tree and thyme essential oils extracted by soxhlet method against Microsporum canis, Trichophyton tonsurans, T. violaceum, T. verrucosum, and Epidermophyton floccosum. Four nanoparticle compounds exhibited antifungal activity which were: Ag0.49Cr2.51O4, Ag0.99Fe1.01O3, CoLa0.019Fe1.981O4, and Co0.99Fe1.99O4 against all tested dermatophytes. Maximum inhibition was recorded in the cases of Ag0.99Fe1.01O3, Ag0.99Fe1.01O3 + cinnamon against M.canis. Least minimum inhibitory concentrations were attained by Cinnamon against M. canis, Ag0.99Fe1.01O3 against M.canis, T. tonsurans, and T.violaceum, Ag0.99Fe1.01O3+Cinnamon against M. canis, T. violaceum and, T. verrucosum, Ag0.99Fe1.01O3 + Clove, and Ag0.99Fe1.01O3 + Lemongrass against M. canis. The study showed promising results regarding the synergistic antifungal efficacy of nanoparticle compounds combined with essential oils in the cases of Ag0.99Fe1.01O3 with cinnamon, Ag0.99Fe1.01O3 with clove and Ag0.99Fe1.01O3 with lemon grass against all tested dermatophytes.

Phytotherapeutic potential of Artemisia ludoviciana and Cordia boissieri extracts against the dermatophyte Microsporum canis

Abstract Introduction Microsporum canis is a dermatophyte that mainly affects dogs and cats. However, it can be transmitted to humans by direct contact. This makes it one of the most frequent causative agents of dermatophytosis in humans, reflecting the frequent human close relationships with pets. Conventional treatment relies on antifungal pharmacological agents. However, errors in application have led to the occurrence of fungal resistance and toxic effects. Consequently, new therapeutic alternatives are needed for M. canis infections. Plant extracts have been explored as phytotherapeutics for the treatment of dermatophyte infections, which prompted an attempt to apply extracts of the ethnopharmacologically important plants Artemisia ludoviciana and Cordia boissieri. Material and Methods Methanolic extracts of these two plants were obtained using a Soxhlet method and were characterised by phytochemical screening. Extracts were evaluated against a M. canis commercial strain (ATCC-11621) using the microdilution method described in the Clinical and Laboratory Standards Institute protocol M38-A, determining its minimal inhibitory concentration (MIC) and minimal fungicidal concentration (MFC). Subsequently, these concentrations were tested in a human keratinocyte human cell line. Results Artemisia ludoviciana and C. boissieri extracts showed MIC values of 2,500 and 1,250 µg/mL, and MFC values of 5,000 and 2,500 µg/mL against M. canis, respectively. These extracts did not inhibit HaCaT cell proliferation in vitro. Conclusion The evaluated extracts showed potential for the treatment of M. canis fungal infections. However, further studies on their phytochemical characterisation, purification, clinical safety and formulation are required.

A systematic review on the emergence of terbinafine-resistant Trichophyton indotineae in Europe: Time to act?

There is a recent growing global concern regarding the rise in antifungal resistance of dermatophytosis. The emergence of terbinafine-resistant Trichophyton indotineae (T. indotineae), previously known as Trichophyton mentagrophytes genotype VIII, is particularly alarming given that terbinafine is considered the treatment of choice for dermatophyte infections and the limited number of available antimycotics. This strain surfaced in the Indian subcontinent in the mid-2010s and more recently there have been reports of its arrival in Europe. The objective of this review is to document the presence of terbinafine-resistant T. indotineae in Europe with the aim to guide antifungal stewardship and ultimately prevent the spread of resistance. This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic literature search was performed using PubMed, Scopus and Web of Science databases. We extracted information from 16 studies published between 2019 and 2023 that described a total of 63 cases of antifungal-resistant dermatophytosis caused by T. indotineae in Europe. Antifungal susceptibility testing (AFST) revealed a wide range of terbinafine minimum inhibitory concentrations (MICs), varying from 0.014 to ≥16 μg/mL. However, these values are hard to interpret due to variations among used methodologies as well as the lack of clinical breakpoints. In all cases included in this study, elevated terbinafine MICs were associated with mutations in the squalene epoxidase (SQLE) gene. Itraconazole was the most frequently used alternative to terbinafine in this study and complete remission of tinea lesions after treatment switch was shown. Nevertheless, relapse rates are concerningly high. We propose the implementation of surveillance programmes for a fast identification through sequencing of T. indotineae (and SQLE mutations) and standardization of procedures for AFST to facilitate the establishment of clinical breakpoints and enable guidance on the appropriate use of antifungals.

Catalase Deactivation Increases Dermatophyte Sensitivity to ROS Sources.

As the leading cause of fungal skin infections around the globe, dermatophytes are responsible for a multitude of skin ailments, ranging from athlete's foot to ringworm. Due to the combination of its growing prevalence and antifungal misuse, antifungal-resistant dermatophyte strains like Trichophyton indotineae have begun to emerge, posing a significant global health risk. The emergence of these resistant dermatophytes highlights a critical need to identify alternative methods of treating dermatophyte infections. In our study, we utilized a 405 nm LED to establish that blue light can effectively inactivate catalase within a variety of both susceptible and resistant dermatophytes. Through this catalase inactivation process, light-treated dermatophytes were found to exhibit increased sensitivity to reactive oxygen species (ROS)-producing agents, improving the performance of antimicrobial agents such as H2O2 and amphotericin B. Our findings further demonstrate that light-induced catalase inactivation can inhibit the formation and polarized growth of hyphae from dermatophytes, suppressing biomass formation. Thus, by increasing ROS sensitization and inhibiting hyphal development, catalase-deactivating blue light offers a potential non-invasive and non-drug-reliant method of managing dermatophyte infections, opening new avenues for the potential treatment of these common infections in conjunction with existing treatments.

Comparative Analysis of Imidazole and Urtica dioica Emulsions in the Management of Dermatophytic Infections

This study explores the epidemiological distribution and antifungal efficacy of treatments against common dermatophytic infections, which predominantly include species from the genera Trichophyton, Microsporum, and Epidermophyton. These infections are significant due to their prevalence and the challenge posed by recurrence and resistance. Between January and September 2022, 35 fungal samples were collected from a dermatological clinic and analyzed using various growth media. Our research focused on evaluating the antifungal effectiveness of a synthetic imidazole emulsion (CSI), an antibiotic, and a natural emulsion from Urtica dioica (CSP). Results revealed that CSI and antibiotic treatments were significantly more effective across all tested species compared to CSP, with CSI often showing superior or comparable efficacy to antibiotics. The findings underscore the robust antifungal properties of imidazole derivatives and suggest a potential limitation in the therapeutic utility of U. dioica extracts. The study highlights the need for continued exploration of innovative treatments and the development of effective management strategies for fungal infections, considering the variance in species prevalence and treatment response.

An Unusual Case Report of Iatrogenic Metrorrhagia and Hematochezia Following Itraconazole

Abstract Itraconazole is an effective triazole antimycotic drug that has a desirable pharmacokinetic profile to combat various fungal pathogens. It acts by inhibiting ergosterol biosynthesis in fungal cell membranes. Itraconazole is not totally selective toward Cytochrome P450 family 3 subfamily A member 4 (CYP450 3A4), but exhibits the most potent inhibition of CYP450 3A4. Thus, these drugs interfere with CYP450 3A4 proteins expressed in the liver, intestine, kidney, adrenals, ovary, and testis. We present a case report of metrorrhagia and hematochezia following intake of itraconazole, a commonly used azole drug against dermatophytic infection. This article strongly highlights eliciting menstrual history and gynecological- and surgical-related problems before prescribing itraconazole. Also, to be aware of the vaginal bleeding being the unusual side effects of itraconazole.

Epidemiological Study of the most Important Dermatophyte Infections in Musayyib General Hospital, Iraq

Background: Dermatophytes are keratophilic fungi that consider exogenous organisms, and cause serious infections of the skin, hair, and nails. The main goal of the current study is to present a survey of fungal skin infections in Musayyib general hospital of Babylon Province Iraq, through the identification of the incidence of some types of Tineae and the extent of spread in different age groups. Materials and Methods A256 patients clinically suspected of dermatophytosis, 210 were positive in direct examination and/or culture. From the positive patients' sample that includes skin scrapping, hair fragments, and nails Results The current study showed that Dermatomycosis infected in males more than females with a ratio of 151 (71.90 %) males and 59 (28.09%) females. The highest percentage of infection with Tinea capitis appeared in males , while the lowest percentage of infection with Tinea ungums with a rate equal between males and females. According to age groups. Conclusions According to the findings of the study, it absolves that although Covid 19 pandemic the world went through fundamental changes by increasing the level of understanding and awareness of people to use different sterilizers and detergents. In addition to reducing contact between people and taking care of personal hygiene. Unfortunately, these procedures did not have a positive effect on reducing dermatophytosis infection in Musayyib General Hospital.

CHARACTERISTICS OF DERMATOMYCOSIS AGAINST THE BACKGROUND OF HIV INFECTION

Background. In the population of HIV-infected patients, superficial mycoses may have different clinical manifestations, evolution, and etiology, in contrast to those found in the population of people not infected with HIV. Aim: to describe superficial lesions of fungal etiology in HIV-infected patients and to compare them with a group of patients with onychomycosis of the feet who did not have HIV infection and concomitant diseases. Materials and methods. 63 patients with lesions of the skin and its appendages of fungal etiology were examined (30 HIV-positive patients and 33 individuals who made up the control group). We analyzed the location of the lesion, the time of development, and performed a mycological examination of skin samples with suspected fungal etiology of the lesion. Results. A statistically significant difference was found between HIV-infected patients and examined individuals of the control group in terms of the number of cases of Tinea unguium. The clinical picture of bedwetting was brighter in the group of HIV-positive patients. In HIV-infected patients, dermatophyte infection of the foot (Tinea pedis) and intertrigo of the feet (ringworm) are diagnosed significantly more often, compared to the group of patients with onychomycosis of the feet who did not have HIV infection and concomitant diseases (p<0.05-0.01 ). It is noteworthy that sedation always occurred under conditions of HIV load ≥50 copies/ml and the number of CD4+-lymphocytes <500 cells in 1 mm3 of blood serum. The clinical picture of onychomycosis in the compared groups also has differences. Thus, onycholysis and hyperkeratosis are statistically more common in HIV-infected persons (p<0.001). Onychodystrophy was characteristic only for patients with onychomycosis of the feet who did not have HIV infection and concomitant diseases (p<0.01). Distal-lateral subungual onychomycosis and white superficial onychomycosis were mainly caused by dermatomycetes, proximal subungual onychomycosis by yeast and mixed infection, and total dystrophic onychomycosis was usually caused by filamentous non-dermatomycetes. Conclusion. A relationship was established between the clinical forms of onychomycosis of the feet of HIV-infected patients and the types of the pathogen (χ2=6.483; df=2; p<0.05).