Patient description: Fernandez is a 41 year man who is a professional soccer player. He came to the clinic with itchy foot. Physical exam revealed localized scaling and maceration between the third and fourth of his right toe. It became inflamed and sore, with mild fissuring. The dorsum and sole of the foot was unaffected. There is no pus or tearing in the affected area. He didn't use ant topical ointment on the lesion and has no positive history for any underlying disease such as DM. He smokes 15 cigarettes per day and drinks a beer per day. His family history is positive for hyperlipidemia in her mother and MI in her father. He is in relation with several partners and use condom during the intercourse. His physical exam and lab studies were normal otherwise. Tinea pedis infection confirmed as his diagnosis by the observation of segmented fungal hyphae during a microscopic KOH wet mount examination.

Clinical trial eligibility criteria: eligible ages (years): 0.0-100.0,  Chronic Mucocutaneous Candidiasis Invasive Aspergillosis CARD9 APECED Patients: Patients with or without inherited or acquired abnormalities of immune function manifesting mucocutaneous and/or invasive fungal infections are eligible for screening and assessment under this protocol. Specifically, patients must meet all the following in order to participate in this study: Adults or children (regardless of age, gender or ethnicity/race) with a known or yet uncharacterized inherited immunodeficiency and a definitively diagnosed mucocutaneous or invasive fungal infection. OR Adults or children (regardless of age, gender or ethnicity/race) with acquired immunodeficiency and a severe, unusual, persistent or treatment-refractory chronic mucocutaneous fungal infection. OR Adults or children (regardless of age, gender or ethnicity/race) with acquired immunodeficiency and a possible, probable or proven invasive fungal infection (European Organization for Research and Treatment of Cancer / Mycoses Study Group criteria). OR Adults or children (regardless of age, gender or ethnicity/race) with a well-documented prior, unusual, severe, persistent, or treatment-refractory mucocutaneous or invasive fungal infection(s), who have clinically recovered from the fungal infection. OR Adults or children (regardless of age, gender or ethnicity/race) with confirmed or suspected autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) who have not yet developed CMC. Ongoing care by a referring/primary care physician (inside or outside NIH). Willing to allow storage of blood and tissue samples for future analyses. Willing to allow genetic testing from blood, body fluids or tissue specimens. Willing to have HIV testing For Clinical Center inpatients unable to give informed consent due to an illness or cognitive incapacity, a Durable Power of Attorney (DPA) must be available to provide informed consent. No children under the age of 2 years will be seen at the Clinical Center, however they will be able to participate via mail-in specimens Patient Relatives: Individuals (regardless of age, gender or ethnicity/race) who are genetically related to the patient (e.g., mother, father, siblings, children) may be recruited to establish the genetic origin of immune defects that may be identified in the study patients at the discretion of the PI. Relatives must meet all the following in order to participate in this study: Willing to allow storage of blood and tissue samples for future analyses. Willing to allow genetic testing from blood, body fluids or tissue specimens. Willing to have HIV testing Healthy Volunteers: Healthy adults regardless of gender and ethnicity/race between the ages of 18 and 85 years old may be eligible to participate in this study. Healthy volunteers must meet all the following in order to participate in this study: Willing to allow storage of blood and tissue samples for future analyses. Willing to allow genetic testing from blood, body fluids or tissue specimens. Willing to have HIV testing Able to provide informed consent NIH employees are eligible  Patients: A patient will not be eligible if he/she has any of the following: Any condition which, in the investigator s opinion, may interfere with the evaluation of a co-existing abnormality of immunity that is the subject of study under this protocol. Any condition which, in the investigator s opinion, places the patient at undue risk by participating in the study. Unwillingness to undergo testing or procedures associated with this protocol. Hemoglobin of < 7 gm/dL. If a patient is enrolled solely to obtain left-over pathology specimens, saliva, a buccal sample, skin swab, vaginal swab, or a stool sample, this will not apply as there will be no blood withdrawal. Patient Relatives: A genetically related relative will not be eligible for this study if he/she has any condition which, in the investigator s opinion, may interfere with the evaluation of an immune system abnormality that is the subject of study under this protocol. Healthy Volunteers: A healthy volunteer will not be eligible if he/she has any of the following: HIV infection. History of recurrent or severe infections. History of an underlying malignancy or receipt of cancer chemotherapy within the past 5 years Receipt of systemic corticosteroids or other systemic immunosuppressants/immunomodulators within the past 30 days Pregnancy or lactating History of heart, lung, kidney disease, or bleeding disorders