Onyxis et ulcérations cutanées à Fusarium solani chez un diabétique

A non-insulin dependant diabetes patient, presented bilateral cutaneous ulcers of the lower limbs associated with pachyonychia of the big toenails. Fusarium solani was isolated from all sites. Local treatment with bifonazole and urea (Amycor onychoset®) was effective but some new positive samples of F. solani associated with the diabetes as the main risk factor, led us think F. solani was the pathogen for the nails and that it also had an aggravating effect on the ulcers. Antifungal susceptibility testing of the filamentous fungi showed a multiresistant pattern. Local treatment alone was prescribed. After 3 months, the lesions had healed and mycological examinations of samples were negative. Treatment continued for 3 more months. This paper presents the diagnosis and the therapeutical approaches used for onyxis and cutaneous fusariosis.