Be Bold to Track the Mold: An Interdisciplinary Approach. A Case Series on Rare Primary Dermal Aspergillosis

Introduction: Aspergillus is the most common ubiquitous opportunistic mould affecting the immuno-compromised host more frequently than immuno-competent host. Isolated primary cutaneous aspergillosis in an immunocompetent host is a rare entity and FNAC acts as a mainstay in primary morphological diagnosis of the same. To prove the role of FNAC as a simple and efficient diag Aim: nostic modality for cutaneous aspergillosis and to correlate the cytology findings with the results of microbiological work up to establish the causative agent. Material And Methods: FNAC was performed in 5 patients presented with dermal based lumpy-bumpy lesion. Smears were stained with H&E and PAS. Samples were sent to microbiology department confirmation of the species. 5 Cases of cutaneous asperg Results: illosis were diagnosed primarily through FNAC, which was later aspergillus species were confirmed on culture. Out of 5 cases, culture showed Aspergillus flavus (2 cases), Aspergillus fumigatus (1 case) and Aspergillus niger (1 case). One case was inconclusive. - Breach i Discussion n primary cutaneous defence secondary to trauma is the root cause of Primary cutaneous Aspergillosis (PCA). Hence farmers are the easy victims. Interdisciplinary diagnostic approach in form of cytological examination (FNAC) and microbiological examination (Fungal culture, KOH mount, LPCB mount) is must to pin point causative agent. Aspergillus a rare cause of cutaneous mycosis, requiring high degree of suspi Conclusion: cion as they can present with non - specific clinical features masquerading from non-neoplastic to aggressive neoplastic lesion. Interdisciplinary diagnostic approach is must for targeted medical and surgical management to reduce morbidity.