Abstract

Diabetic patients are pre-disposed to developing toe-nail onychomycosis due to yeasts, dermatophytes and non-dermatophytic molds and rarely by Curvularia species. However, hypertrophic proximal onychomycosis by Curvularia species in diabetic patient is not reported frequently. A 64-year-old diabetic male presented with proximal nail bed mass with total nail dystrophy associated with pain and purulent discharge for 6 months. Differential diagnosis included onychomycosis and squamous cell carcinoma of the nail unit. Potassium hydroxide mount of the nail clipping revealed thin septate hyphae. Biopsy from nail bed mass did not reveal any features suggestive of malignancy. Fungal culture in Sabouraud Dextrose Agar medium revealed growth of Curvularia species. The patient reported significant improvement after 8 weeks of oral itraconazole. In diabetic patients, Curvularia species can rarely cause hypertrophic proximal onychomycosis associated with purulent discharge.