Cutaneous Mucormycosis: Mycological, Clinical, and Therapeutic Aspects

Abstract Cutaneous mucormycosis (CM) is caused by ubiquitous filamentous fungi belonging to the order Mucorales. It is a rare, emerging mycosis, with increasing incidence since the last two decades, only surpassed by rhinocerebral and pulmonary mucormycosis. CM can be further classified in primary and secondary clinical forms. Primary cases can be seen on immunocompetent patients, frequently due to traumatic injuries, while in immunocompromised patients (those with diabetes mellitus or hematologic malignancies), lesions can arise at catheter insertion sites or after the use of contaminated adhesive tapes. Clinical features of primary cutaneous mucormycosis (PCM) are necrosis, followed by ulceration, generally associated to good prognosis. Secondary cutaneous mucormycosis (SCM) is related to rhinocerebral and/or disseminated forms. SCM usually starts as a palpebral fistula, as an erythematous area that rapidly evolves to necrosis and ulceration, related to worse prognosis. Direct examination, cultures, skin biopsies, and molecular tests are performed to diagnose both clinical forms. Liposomal amphotericin B (LAmB) in combination with surgical debridement constitutes the treatment of choice; however, for SCM, the addition of posaconazole or caspofungin is recommended.
Source: Current Fungal Infection Reports - Category: Infectious Diseases Source Type: research