Dermatophytoma was first described in 1998 to complicate toenail infections and is characterized by fungal elements compacted into a fungal ball.1 Clinically, it appears as a dense white or yellow linear or round white patch within the nail plate. Cutting back the overlying nail plate reveals a hyperkeratotic mass that can be easily removed because it is not adherent to the nail plate or nail bed, and histologic analysis reveals a dense mass of abnormal-appearing, densely walled, dermatophyte hyphae.1,2 The standard diagnostic test for onychomycosis involves clinical suspicion and at least 1 positive finding on a laboratory test, but the diagnosis of dermatophytoma is much less straightforward and has rarely been described in the literature.
Verne SH, Chen L, Shah V, Nouri K, Tosti A. Optical Coherence Tomography Features of Dermatophytoma. JAMA Dermatol. 2018;154(2):225–227. doi:10.1001/jamadermatol.2017.4590
Coronavirus Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: