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March 1990


Author Affiliations

Department of Dermatology University of Texas Medical Branch Galveston, TX 77550

Harvard Community Health 199 Chelmsford St Chelmsford, MA 01824

Arch Dermatol. 1990;126(3):402. doi:10.1001/archderm.1990.01670270134029

To the Editor.—  Onychomycosis is the most common nail disease. Based on the site of fungal infection, types of fungus, and result of different host-parasite relationships, those infections can be classified into five groups: (1) distal subungual onychomycosis, (2) superficial white onychomycosis, (3) proximal subungual onychomycosis, (4) chronic mucocutaneous candidiasis, and (5) total dystrophic onychomycosis.1,2 All types of onychomycosis can progress to total dystrophic onychomycosis that involves the entire nail. We report a case of proximal subungual onychomycosis (PSO) in an immunosuppressed patient. Another case of PSO in a patient with acquired immunodeficiency syndrome has been reported previously from our clinic.3

Report of a Case.—  A 36-year-old white man presented to the dermatology clinic on June 1988, with white discoloration of the proximal portion of his fingernails for the previous 2 months. He received a renal transplant in 1979 and, since then, he has been receiving oral azathioprine

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