Cutaneous Aspergillosis Research Articles

Acquiring accidental aspergillosis

Aspergillus is an all-pervasive mold with the potential to cause severe invasive infections in the immunocompromised. A rare cutaneous manifestation of Aspergillus infection, primary cutaneous aspergillosis (PCA), occurs in just 1-5% of invasive aspergillosis cases. Prompt treatment is indicated as PCA may progress to a disseminated state. We present a unique case of an immunocompetent individual diagnosed with PCA two weeks after trauma and subsequent surgery.

Molds and More: Rare Fungal Infections in Preterm Infants

Extreme immature infants are at an increased risk of fungal infection due to immaturity of the skin barrier and the immune system. Besides Candida infections, in particular, Aspergillus may cause life-threatening diseases in preterm infants. Frequently, Aspergillus primarily affects the skin and may cause extensive damage. We searched our hospital database for fungal infections other than Candida in preterm infants treated between 2015 and 2020 at our level III neonatal intensive care unit of the University Hospital of Cologne. In total, 13 preterm infants were identified. Of these, 11 had cutaneous Aspergillosis, one infant had severe enterocolitis caused by Aspergillus and Rhizopus and one had invasive intraabdominal Trichosporon mucoides infection. All infants were born <24 weeks of gestation, were delivered due to premature labor or chorioamnionitis, and had received prenatal steroids and/or hydrocortisone. Voriconazole and liposomal Amphotericin B were first-line treatments and the length of treatment varied between 3 and 148 days. Two infants died associated with severe infection. Liver toxicity was observed in six infants treated with Voriconazole. Therapeutic drug management for Voriconazole was performed in four infants. Target levels were not achieved by the doses that are recommended. Rare fungal infections, predominantly cutaneous Aspergillosis affects the most immature preterm infants and may cause severe disease. Treatment with Voriconazole has a high rate of liver toxicity and target levels are difficult to achieve in extremely immature infants.

Encouraging Survival and High Rates of Toxicity: Allogeneic Hematopoietic Cell Transplantation after Anti-CD19 Chimeric Antigen Receptor T-Cell Therapy in Aggressive Lymphoma Patients

BackgroundApproximately 60% of patients with aggressive large B-cell lymphoma (ALBCL) treated with anti-CD19 chimeric antigen receptor T-cell (CAR T) will ultimately progress or relapse. Allogeneic hematopoietic cell transplantation (Allo-HCT) is a potentially curative treatment for lymphoma patients who relapse after CAR T-cell therapy. However, the efficacy and toxicity profile of allo-HCT following CAR T in aggressive lymphoma patients are not well defined. Herein, we report our experience.Methods and patientsA total of 29 adult patients (median age 45 years [IQR 40-55]) who received allo-HCT for ALBCL between 2017 to 2021 were included. All patients were previously treated with anti-CD19 CAR T-cell (academic CD28-costimulatory domain product [n=23, 79%]; tisagenlecleucel [n=6, 21%]). Twenty-five (86%) and 4 (14%) had a diagnosis of DLBCL and PMBCL, respectively. Median number of previous therapies before CAR T was 3 (IQR 2-4). Eight (28%) patients underwent a previous autologous HCT. No patient underwent a previous allo-HCT. Median hematopoietic cell transplantation-specific comorbidity index (HCT-CI) was 3 (IQR 2-3). Six (21%) patients had a Karnofsky performance status ≤ 80%.Allo-HCT was performed at a median of 4.1 months (IQR 2.2-5.4) post CAR T, with the majority of patients (48%) receiving transplant as first-line post CAR T. Reasons for allo-HCT were consolidation of complete response (CR) to CAR T in high-risk disease (n=4, 14 %), partial response (PR) to CAR T (n=7, 24%) and relapse /progression after CAR T (n=18, 62%). Disease response before allo-HCT was CR (n=11, 38%), PR (n=11, 38%) and progressive disease (n=7, 24%). Donors were matched siblings (n=13, 45%), matched unrelated (n=9, 31%) and mismatched unrelated /haploidentical donors (n=7, 24%). Myeloablative and reduced-intensity conditioning regimens were given in 13 (45%) and 16 (55%) patients, respectively. Methotrexate-based graft versus host disease (GVHD) prophylaxis was used in 20 (69%) patients. Antithymocyte globulin and post-transplantation cyclophosphamide were administered in 13 (45%) and 5 (14%), respectively.ResultsMedian follow-up was 33 months (IQR 13-41). Neutrophil engraftment rate was 93% (two early deaths before engraftment due to infection and multi-organ failure). Two-year overall survival (OS) and progression-free survival were 44% (95% CI: 28-68) and 30% (95% CI: 17-55), respectively. Two-year cumulative relapse incidence and non-relapse mortality were 45% (95% CI: 25-63) and 25% (95% CI: 11-43), respectively (Figure). In a univariable Cox regression, factors significantly associated with a shorter OS were number of interim therapies between CAR T and allo-HCT (Hazard ratio [HR] 2.2 [95% CI: 1.3-3.9], p 0.006) and the length of time between CAR T and allo-HCT (HR 3.8 [95% CI: 1.2-12.1], p 0.02). Best response to CAR T and disease response before allo-HCT were not significant risk factors for a shorter OS.High rates of grade ≥ 3 hyperbilirubinemia (total bilirubin >3 ULN) and hepatic sinusoidal obstruction syndrome (SOS) were observed in 10 (35%) and 5 (17%) patients, respectively. These liver insults were not contributed to acute GVHD. All patients with SOS were treated with defibrotide and two patients died from related complications. Interestingly, 4/5 patients with SOS were conditioned with fludarabine and thiotepa.One-year cumulative incidence of grade II-IV acute GVHD was 34% (n=10; 95% CI: 18-52). Notably, 6 patients had grade IV acute GVHD, 4 of them were refractory to corticosteroids and 3 patients died due to acute GVHD. Two-year cumulative incidence of chronic GVHD was 23% (n=5; 95% CI: 7-46). Chronic GVHD was considered extensive in 4 of them.Bloodstream bacterial infection was documented in 11 (38%) patients. Invasive fungal infection occurred in 6 (21%) patients and included brain aspergillosis, cutaneous aspergillosis, 2 lung aspergillosis, hepatosplenic candidiasis and an ocular mucor mycosis.ConclusionAllogeneic hematopoietic cell transplantation is feasible after failure of CAR T-cell therapy in aggressive lymphoma, although with a relatively high rate of SOS and severe acute GVHD in these heavily pretreated patients. Overall survival is encouraging with approximately 30% of patients remaining alive and disease-free at two years. Larger scale studies are required to better define the role of allo-HCT in this setting. [Display omitted] DisclosuresShouval: Medexus: Consultancy. Jacoby: NOVARTIS: Honoraria, Membership on an entity's Board of Directors or advisory committees. Avigdor: Takeda: Consultancy, Honoraria; Janssen: Research Funding; BMS: Research Funding; Gilead: Consultancy, Honoraria; Pfizer: Consultancy, Honoraria.

A review on antifungal agents against Candida albicans and Aspergillus niger

Candidiasis is the fungal infection caused by Candida albicans. It causes different type of candidiasis infections in the blood, heart, eyes, brain, bones also other parts of our body. Different types of candidiasis are vaginal candidiasis, pulmonary candidiasis, oral candidiasis. It may be acute or chronic. It can be cured by using natural compounds or synthetic compounds or semisynthetic compounds. Apergillosis is the fungal infections in human caused by Aspergillus niger. Aspergillosis infections are classified into allergic pulmonary sinusitis, cutaneous aspergillosis, invasive aspergillosis, chronic necrotising pulmonary aspergillosis can be cured by using synthetic compounds like intravenous injections, oral medicines of capsules, tropical medicines like creams and some other natural products from plants. Natural products like saponins, flavonoids, alkaloids, xanthones, lectins and polypeptides, quinones, terpenoids, coumarins, essential oils and other compounds are the secondary metabolites extracted from the plants. Those plants are effective against fungal infections. Synthetic drugs like Azole group of drugs composed of imidazoles which includes miconazole, clotrimazole, ketoconazole, and triazoles include itraconazole, Posaconazole, isavuconazole are used to inhibit the ergosterol synthesis of cell membrane of fungi. Echinocandins are antifungal agent and it is used to disrupt the cell wall of fungi and inhibiting the synthesis of beta- 1,3 glucan fungal cell wall. Echinocandins are classified into caspofungin, anidulafungin, micafungin which having antifungal activity and amphotericin B used to treat both candidiasis and aspergillosis. Combination of drugs like synthetic drugs and natural compounds used to treat Candidiasis and Aspergillosis. Comparison and effectiveness of drugs depends upon the infections they are getting affected. Amphotericin B and azole group of drugs are commonly more effective than other group of drugs, but ketoconazole is widely used. Adverse effects of antifungal agents include, skin rashes, irritation, itching, nausea and vomiting, fever, abdominal pain, muscle and joint pain, etc.

Primary cutaneous aspergillosis caused by Aspergillus welwitschiae: A case report

Primary cutaneous aspergillosis caused by <i>Aspergillus welwitschiae</i>: A case report

Pioneers in Dermatology and Venereology: an interview with Professor Ricardo Luis Galimberti.

Pioneers in Dermatology and Venereology: an interview with Professor Ricardo Luis Galimberti.

Aspergillus Genus and Its Various Human Superficial and Cutaneous Features.

Superficial and cutaneous aspergillosis is a rare fungal disease that is restricted to the outer layers of the skin, nails, and the outer auditory canal, infrequently invading the deeper tissue and viscera, particularly in immunocompromised patients. These mycoses are acquired through two main routes: direct traumatic inoculation or inhalation of airborne fungal spores into paranasal sinuses and lungs. Lesions are classified into three categories: otomycosis, onychomycosis, and cutaneous aspergillosis. Superficial and cutaneous aspergillosis occurs less frequently and therefore remains poorly characterized; it usually involves sites of superficial trauma—namely, at or near intravenous entry catheter site, at the point of traumatic inoculation (orthopaedic inoculation, ear-self-cleaning, schizophrenic ear self-injuries), at surgery incision, and at the site of contact with occlusive dressings, especially in burn patients. Onychomycosis and otomycosis are more seen in immunocompetent patients, while cutaneous aspergillosis is widely described among the immunocompromised individuals. This paper is a review of related literature.

Cutaneous Aspergilosis Caused by Aspergillus Flavus: A Case Report

Background: Cutaneous aspergillosis occurs relatively less frequent and therefore remains poorly characterized. Cutaneous aspergillosis can be as primary or secondary infection. Primary cutaneous aspergillosis usually involves sites of skin injury, intravenous catheter, traumatic inoculation, and associated with occlusive dressings. Secondary lesions result from contiguous extension from infected underlying structures or from widespread blood-borne seeding of the skin. Purpose: To know the skin manifestation, efflorence, examination and therapy of cutaneous aspergillosis. Case: A man complaint itchy redness macule and pimples on the right arm since 2 weeks. Initially just felt a little then expands. Patients with post operative brachial injury and uses a cast during one month. On examination there are erythematous macule unsharply marginated with papules. Potassium hydroxide examination, shows conidiophores, dichotomously branching and septate hyphae appropriate description with Aspergillosis Sp. Cultures found grow granular colonies, flat often with radial grooves, yellow at first but quickly becoming bright to dark yellow-green with age, For the identification microscope from the culture specimen there was conidia, phialde, conidiophore and vesicle that suitable with Aspergillus flavus. Patients received itraconazole 2 x 200 mg for 6 weeks and obtained satisfactory results. Discussion: Healthy hosts can develop cutaneous aspergillosis in surgical wounds, by traumatic inoculation, at sites associated with occlusive dressings. In some instances, a presumptive diagnosis of primary cutaneous aspergillosis can be made immediately by examining a potassium hydroxide preparation and culture. Conclusion: Diagnose of cutaneous aspergillosis can establish by potassium hydroxide and culture examination, therapy with itraconazole 2x 200mg give satisfactory results.

Cutaneous Aspergillosis in Children and Adolescents

This is a general review of the disease in this article, especially of the clinical features, diagnosis, new treatments and preventive measures. Diagnostic methods in pediatric population to confirm the diagnosis of aspergillosis and typify the etiologic agent are based on the use of molecular biology through PCR techniques. Currently, the treatment of choice for cases of primary cutaneous aspergillosis is liposomal amphotericin B or itraconazole alone or synergistically, uuse of voriconazole, posaconazole, or caspofungin is recommended as a second-line management. Cutaneous aspergillosis is a rare condition in immunocompetent individuals and is more frequently observed in immunosuppressed patients. Considering the pediatric population as a specific case, it more commonly occurs in individuals suffering from a hemato-oncological disease. Asperillus flavus and A. fumigatus are the main pathogens responsible for primary and secondary (invasive) cutaneous aspergillosis, respectively. The clinical picture develops after direct inoculation of the fungus by contiguity of infected cavities or secondary to the presence of a distant mycotic focus that reaches the skin and its annexes by hematogenous dissemination. Owing to the rapid progression of the disease, a delay in initiating proper management impacts patient mortality. In case of children and adolescents, clinical suspicion in individuals with risk factors should be the main argument for starting pharmacological management in a timely manner.

Primary Cutaneous aspergillosis: Rash in an Infant Born with Less Weight

Primary cutaneous aspergillosis (PCA) is one of several invasive fungal infections that have increased in incidence in the last four decades. We present an instance of an amazingly low birth weight newborn child brought into the world at 24 weeks growth determined to have cutaneous aspergillosis, featuring the danger factors and clinical discoveries related with neonatal PCA. Furthermore, we talk about utilization of serum galactomannan testing just as mix amphotericin B and voriconazole treatment. Early acknowledgment of injuries normal for PCA is needed to guarantee brief finding and treatment, conceivably forestalling scattering with ideal results [1].

Primary Cutaneous Aspergillosis in a Patient with CARD9 Deficiency and Aspergillus Susceptibility of Card9 Knockout Mice.

We describe a case of primary cutaneous aspergillosis caused by Aspergillus fumigatus, and elucidate the underlying genetic and immunological mechanisms. Routine clinical and laboratory investigations were performed. Whole-exome sequencing of the patient's DNA suggested the presence of a CARD9 mutation, which was confirmed by Sanger sequencing. Innate and adaptive immunological responses of patient-derived CARD9-deficient cells were evaluated with ELISA and flow cytometry. Cutaneous and pulmonary aspergillosis models were established in Card9 knockout (KO) mice, which were compared with wild-type and immunosuppressed mice, to explore the pathogenesis and Aspergillus susceptibility. A 45-year-old man presented with a 37-year history of skin lesions on his face. A diagnosis of primary cutaneous aspergillosis was made through histopathology, immunohistochemistry, and tissue culture. Sanger sequencing of CARD9 showed a homozygous frame-shift mutation (c.819_820insG, p.D274fsX60), which led to the lack of CARD9 expression. Peripheral blood mononuclear cells from the patient showed selective impairment of proinflammatory cytokines, and Th1-, Th17-, and Th22-associated responses upon fungus-specific stimulation. The cutaneous aspergillosis model established in Card9 KO mice presented with persistent infection, with fungal germs and short hyphae in tissue, consistent with the patient's lesions. Skin lesions in immunosuppressed mice were more severe, and led to death. Unlike our patient, Card9 KO mice were relatively susceptible to pulmonary aspergillosis, with reasons to be investigated. This is, to our knowledge, the first report that links cutaneous aspergillosis to CARD9 mutation. This work enriches both the phenotypic spectrum of CARD9 deficiencies and the genetic background of cutaneous aspergillosis.

Cutaneous aspergillosis in an immunocompetent patient: a case report

Cutaneous aspergillosis is a rare disease that is usually seen in immunosuppressed patients. It is rarely found in immunocompetent patients and it is mostly caused by Aspergillus. flavus, Aspergillus fumigatus, and rarely by Aspergillus niger. Cutaneous Aspergillosis is of two types: primary or secondary. Primary cutaneous aspergillosis frequently involves sites of skin injury, at or near intravenous catheter sites, at sites associated with occlusive dressings, at sites of traumatic inoculation, surgery or burns. Secondary cutaneous lesions occur as a result of either from widespread blood-borne seeding of the skin or it may occur from contiguous extension to the skin from an infected underlying structure. The current study is presenting a case of a 25-year-old female, a farmer by occupation, presented with multiple scaly plaques and verrucous nodules with a past history of trauma over knee 3 years back. After trauma she initially noticed lesions over knee followed by the elbow, face and oral lesions noticed 7 months back. There was no present or past history of weight loss, anorexia and serological tests were negative for HIV. One year back she was diagnosed as lupus vulgaris and received Anti-Tubercular treatment without much benefit. She came to our hospital where biopsy from lesions over elbow revealed dense inflammatory exudate, septate fungal hyphae showing acute angle branching on H and E stain and PAS stain, which is suggestive of aspergillosis. Scrapping from oral lesion also revealed inflammatory cells with septate fungal hyphae with acute angle branching on PAP stain. Histopathological, cytological study and fungal culture show fungal infection caused by Aspergillus niger. In cutaneous aspergillosis, surgical excision alone or combination with drug therapy was found to be curative. The present case report was important due to its rarity.

Molecular characterization of fungi causing colonization and infection in organ transplant recipients: A one-year prospective study.

Background and Purpose:Organ transplant recipients are vulnerable to fungal infections. The aim of this study was to determine the prevalence of fungal colonization and infections among patients who underwent various transplantations and molecularly characterize the etiological agents.Materials and Methods:This study was conducted on candidates for transplantation in Imam Khomeini Hospital, Tehran, Iran, from April 2017 to April 2018. All patients were monitored for fungal colonization or infections before and after transplantation. Isolated fungi were identified using molecular methods.Results:A total of 125 patients, including 86 males and 39 females, with the mean age of 52.2 years participated in the study (age range: 15-75 years). Out of 125 patients, 84 (67.2%) cases had fungal colonization that appeared pre- and post-transplantation in 21 and 63 cases, respectively (alone or concurrent with another infection in 55 and 29 cases, respectively). In addition, a total of 39 episodes of fungal infections were diagnosed in 36 (28.8%) recipients (alone or concurrent with colonization in 7 and 29 cases, respectively). Out of the 39 fungal infections, 9 cases appeared pre-transplantation, while the other 30 cases occurred post-transplantation. However, no fungal colonization or infection was observed in 34 (27.2%) patients. Oral candidiasis (n=20) was the most common type of infection, followed by funguria (n=7), onychomycosis (n=5), candidemia (n=3), rhinocerebral mucormycosis (n=1), cutaneous mucormycosis (n=1), cutaneous aspergillosis (n=1), and peritonitis (n=1). Six yeast species were recovered from colonization cases with the dominance of Candida albicans both before and after transplantation. The observed fungal infections were caused by 11 distinct species, including the members of Candida (i.e., C. albicans, C. glabrata, C. parapsilosis, C. tropicalis, and C. krusei), Aspergillus (i.e., A. oryzae and A. candidus), Rhizopus (i.e., R. oryzae and R. microsporus), Trichosporon asahii, and Trichophyton interdigitale. The results also indicated that the development of a fungal infection post-transplantation was associated with fungal colonization (r=0.0184; P=0.043). Conclusion:Based on the results, fungal colonization was a common finding in transplant recipients at Imam Khomeini Hospital. However, the incidence of fungal infections was comparable with those of other centers. As the oral cavity was the most common site of colonization and infection, it might be beneficial to take further care about the oral health of patients using effective mouthwash.

Primary Cutaneous Aspergillosis Presenting as a Multiloculated Cyst in the Hand

: Invasive aspergillosis typically occurs in immunocompromised patients and results in fatal complications. Musculoskeletal involvement of aspergillosis is extremely rare, therefore, when it occurs, its diagnosis and treatment could be delayed. In this paper, we report a rare case of primary invasive aspergillosis with radiologic findings in a patient with rheumatoid arthritis. A 57-year-old woman presented a palpable mass on the right hand with a previous medical history of long-term use of immunosuppressive agents due to rheumatoid arthritis. Magnetic resonance imaging showed a multilobulated and multiloculated cystic lesion with an enhancing wall. The wall of the cystic lesion showed low signal intensity on T2 weighted images and intermediate to high signal intensity on T1 weighted images. The mass was confirmed as chronic granulomatous inflammation with multiple acute branching and septated fungal hyphae, consistent with invasive aspergillosis. When a superficial multicystic mass in the hand of especially immunocompromised patients is encountered, invasive aspergillosis should be included in the differential diagnosis, although it is rare.

Cutaneous aspergillosis disseminated from invasive pulmonary aspergillosis

Cutaneous aspergillosis disseminated from invasive pulmonary aspergillosis

A curious case of chest wall lump turning out to be isolated primary cutaneous aspergillosis in an immunocompetent female: a case report

Aspergillosis is a fungal infection caused by certain types of mold. Although they are found commonly throughout nature, these molds normally don’t cause problems. Aspergillosis is an uncommon fungal infection in which primary cutaneous sites are very rare. Most cases occur in immunodepressed patients and are disseminated in the blood. We report a 32 year old female with primary cutaneous aspergillosis in an otherwise immunocompetent female with no other systemic manifestation. 32 year old female presenting with left lower chest lump fixated to chest wall. It was thought of as neoplasm clinically and radiologically mostly soft tissue neoplasm and was planned for wide excision of lump with segmental excision of involved rib segment. On histopathological examination of the specimen, it showed aspergillus organisms. It is a case of primary cutaneous manifestation of aspergillosis as fixed chest wall lump with otherwise no Broncho-pulmonary or systemic involvement in an immunocompetent patient. Primary cutaneous aspergillosis presenting as isolated chest wall lump without any Broncho pulmonary or systemic involvement in an otherwise immunocompetent individual is an extremely rare manifestation.

A murine model of cutaneous aspergillosis for evaluation of biomaterials-based local delivery therapies.

Cutaneous fungal infection is a challenging condition to treat that primarily afflicts immunocompromised patients. Local antifungal therapy may permit the delivery of high concentrations of antifungals directly to wounds while minimizing systemic toxicities. However, the field currently lacks suitable in vivo models. Therefore, a large cutaneous wound was created in immunosuppressed mice and inoculated with Aspergillus fumigatus. We fabricated biodegradable polymer microparticles (MPs) that were capable of locally delivering antifungal and characterized in vitro release kinetics. We compared wound bed size, fungal burden, and histological presence of fungi in mice treated with antifungal-loaded MPs. Mice with a cutaneous defect but no infection, mice with infected cutaneous defect but no treatment, and infected mice treated with blank MPs were used as controls. Infection of large wounds inhibited healing and resulted in tissue invasion in an inoculum-dependent manner. MPs were capable of releasing antifungals at concentrations above A. fumigatus Minimum Inhibitory Concentration (MIC) for at least 6 days. Wounds treated with MPs had significantly decreased size compared with no treatment (64.2% vs. 19.4% wound reduction, p = 0.002) and were not significantly different from uninfected controls (64.2% vs. 58.1%, p = 0.497). This murine model may serve to better understand cutaneous fungal infection and evaluate local biomaterials-based therapies. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 107A: 1867-1874, 2019.

Aspergillus fumigatus as an agent of cutaneous aspergillosis in immunocompetent patient: A rare case

Cutaneous aspergillosis occurs relatively less frequent and therefore remains poorly characterized. Previous reports have described cutaneous aspergillosis as primary or secondary infection. Primary cutaneous aspergillosis usually involves sites of skin injury, at or near intravenous access catheter sites, at sites of traumatic inoculation, and at sites associated with occlusive dressings, burns, or surgery. Primary cutaneous aspergillosis almost always seen in immunocompromised patients and the skin involvement occurs due to hematogenous dissemination from a primary focus or contiguous spread from underlying infected tissues. This is a rare case of an-56-years-old-immunocompetence man with chief complaint of wound and swelling at left leg since 1 year ago that worsen in last 2 months. He got a history of scalded by hot water at his left leg 1 year ago and became swollen with multiple wound on its surface. Examination on regio pedis sinistra there is tumor with verrucous surface 10 cm in diameter, hard with multiple uneven edge ulcer 5 cm in diameter and hyperpigmentation macule unsharply marginated arround. Potassium hydroxide examination showed conidiophores dichotomously branching and septated hyphae that suitable with Aspergillosis sp. From cultures there is velvety-dark-green growth. The microscope findings from the culture specimen showed conidophore, metula, vesicle, phialde, and chains of pigmented conidia that suitable with Aspergillus fumigatus. Blood culture examination showed no growth of fungi. HIV rapid test negative results obtained. Patients treated with Itraconazole 2 x 200 mg for 12 weeks and obtained satisfactory result.

Cutaneous aspergillosis in goats and its therapeutic management by tamarind (Tamarindus indica) seed outer coat powder

Cutaneous aspergillosis in goats and its therapeutic management by tamarind (<i>Tamarindus indica</i>) seed outer coat powder

Primary cutaneous aspergillosis in a renal allograft recipient

Cutaneous fungal infection due to aspergillus is relatively less known. Mostly it occurs due to Aspergillus flavus. This entity should be included in differential diagnosis of cutaneous fungal infections