Primary cutaneous aspergillosis in an immunocompetent patient: A rare case from eastern India

Primary cutaneous aspergillosis (PCA) is an uncommon manifestation of Aspergillus infection, typically occurring in immunocompromised individuals. We report a rare case of diffuse PCA in an immunocompetent patient who presented with multiple painless, discharging nodular lesions on the extremities over a 3-month period. Clinical examination revealed multiple nontender swellings with erythema, edema, desquamation, and purulent discharge. Direct microscopy with potassium hydroxide mount revealed thin septate hyphae with acute-angle branching. Fine-needle aspiration cytology and histopathology confirmed fungal elements consistent with Aspergillus . Fungal culture from the biopsy specimen yielded Aspergillus flavus . Based on clinical, cytological, histopathological, and microbiological findings, a diagnosis of PCA was established. The patient was treated with oral itraconazole 200 mg daily but was lost to follow-up. This case highlights the importance of considering fungal infections like PCA in immunocompetent individuals, especially when faced with atypical, nonhealing cutaneous lesions. Early recognition and appropriate antifungal therapy are crucial to prevent potential complications and dissemination.