Photodynamic therapy successfully treats refractory onychomycosis caused by Trichosporon asahii: a case report

•A rare case of onychomycosis caused by Trichosporon asahii.•Combination of fire needle and photodynamic therapy for effective antifungal treatment.•Provide specific treatment details for photodynamic therapy onychomycosis caused by Trichosporon asahii. Onychomycosis, a fungal infection affecting the nail, is characterized by discoloration and thickening of the nail plate and is the most prevalent nail infection globally. We present a case of onychomycosis caused by Trichosporon asahii, a less common etiology. Notably, the patient was successfully treated with a non-traditional antibacterial approach, photodynamic therapy, which has been infrequently documented in the literature for such infections.