Primary Cutaneous Aspergillosis with Clinical Presentation Mimicking Tuberculosis Verrucosa Cutis
DOI:
https://doi.org/10.11594/jk-risk.02.1.8Keywords:
Primary aspergillosis cutis, deep mycosis, tuberculosis verrucosa cutisAbstract
Background: Primary cutaneous aspergillosis (PCA) is a rare invasive fungal infection of the skin that can be life-threatening. This disease is caused by Aspergillus spp and belongs to the deep mycosis (subcutaneous) group.
Case report: A 63-year-old man came with complaint of wound that feels itchy, painful and exudative on right lower leg since 5 years ago. Dermatological examination showed multiple erythematous papules and plaques with verrucous surface partially covered in brownish yellow crust accompanied by xerosis and some ulcers with pus. The proposed differential diagnoses are Tuberculosis verrucosa cutis, Chromoblastomycosis and Mycetoma. The result of tissue culture showed Aspergillus niger. Biopsy result supports the diagnose of deep mycosis. The patient then diagnosed as primary cutaneous aspergillosis, treated with pulse dose Itraconazole and improved clinically within 2 weeks.
Conclusion: Atypical manifestation in this patient gives diagnostic challenge for dermatologist. The importance of establishing diagnosis in patient with deep mycoses are to identify the cause, determine the appropriate treatment and prevent cimplication.
Downloads
References
2. Hay RJ. Deep Fungal Infections. Dalam: Kang S, Amagai M, Bruckner AL, dkk penyunting. Fitzpatrick's Dermatology. Edisi ke 9. McGraw-Hill Education. 2019. 2965-88.
3. Carrasco-Zuber JE, Navarrete-Dechent C, Bonifaz A, Fich F, Vial-Letelier V, Berroeta-Mauriziano D. Cutaneous involvement in the deep mycoses: a literature review. Part I—subcutaneous mycoses. Actas Dermo-Sifiliográficas (English Edition). 2016. 107(10):806-15. https://doi.org/10.1016/j.adengl.2016.05.026
4. Ramali LM. Aspergilosis. Dalam: Bramono K, Suyoso S, Widaty S, Ramali LM, Siswati AS, Ervianti E, penyunting. Mikosis Profunda: Pedoman untuk Dokter dan Mahasiswa Kedokteran. Edisi pertama. Surabaya : Airlangga University Press. 2019. 101-13.
5. Robinson A, Fien S, Grassi MA. Nonhealing scalp wound infected with Aspergillus niger in an elderly patient. Cutis. 2011. 87(4):197-200.
6. Sudarshan R, Nayak K, Kumar P, Kadilkar U. Rare Case of Multifocal Cutaneous Tuberculosis Verrucosa Cutis: Posing Clinical and Histopathological Diagnostic Dilemma. Br J Med Med Res. 2018. 16:1-5. https://doi.org/10.9734/BJMMR/2016/26186
7. Bandyopadhyay A, Majumdar K, Gangopadhyay M, Banerjee S. Cutaneous Chromoblastomycosis Mimicking Tuberculosis Verrucosa Cutis: Look for Copper Pennies. Turk Patoloji Derg. 2015. 31(3):223-25. https://doi.org/10.5146/tjpath.2013.01197
8. Manjumeena D, Sundaramoorthy S. Tuberculosis verrucosa cutis masqerading as chromoblastomycosis – a case report. Our Dermatol. Online. 2018. 9(3):275-78. https://doi.org/10.7241/ourd.20183.10
9. Neki NS, Singh A, Shergill GS, Sidhu PB, Pannu JS, Singh T. Cutaneous Aspergillosis in an immunocompetent patient. Int. j. med. health res. 2016. 2(12):57-58.
10. Rocha P, Pinto R, Rodrigues S, Rodrigues M, Sudhakaran A, Mahajan K. Cytodiagnosis of primary cutaneous aspergillosis in an immunocompetent host. J Cytol. 2016. 33(1):59-60.https://doi.org/10.4103/0970-9371.175532
11. Oak ASW, Baddley JW, Elewski BE. Systemic Antifungals. Dalam: Yamauchi PS, penyunting. Biologic and Systemic Agents in Dermatology. Springer, Cham. 2018. 425–450.
https://doi.org/10.1007/978-3-319-66884-0_40
12. Belgaumkar VA, Chavan RB, Suryataley PR, Salunke AS, Patil PP, Borade SM. Tuberculosis verrucosa cutis: case report of a diagnostic challenge. Int J Res Dermatol. 2018. 4(2):265. http://dx.doi.org/10.18203/issn.2455-4529.IntJResDermatol20181833
13. Queiroz-Telles F, de Hoog S, Santos DW, Salgado CG, Vicente VA, Bonifaz A, dkk. Chromoblastomycosis. Clin microbiol rev. 2017. 30(1):233-76. https://doi.org/10.1128/CMR.00032-16
Downloads
Published
Issue
Section
License
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal the right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors can enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) before and during the submission process, as it can lead to productive exchanges and earlier and greater citation of published work (See The Effect of Open Access).
How to Cite
