Cutaneous presentations of fungal infections in HIV in Australasia include tinea, Candida, Malassezia, cryptococcosis, penicillinosis and pneumocystis.
Dermatophytosis is most commonly due to Trichophytum rubrum, frequently causing tinea cruris, corporis and onychomycosis. Despite ART and ﬂuconazole prophylaxis, superﬁcial dermatophyte infections can be atypical, widespread and refractory in this setting. Dermatophyte infections may also have deep dermal morphologies. These present as multiple ﬂuctuant erythematous ulcerative nodules on the extremities and often are in areas of chronic superﬁcial dermatophytosis. Atypical presentations of T. rubrum also include ﬁrm violaceous nodules and papules due to nodular granulomatous perifolliculitis usually with co-existing onychomycosis and tinea pedis. Proximal nail white onychomycosis is also a marker of HIV infection, although some studies have shown that HIV infection is not associated with an increased susceptibility to dermatophytosis., ,  Culture of the fungal skin or nail scraping may be required if the speciation of the fungus is required or microscopic analysis of the samples give negative results.