Cutaneous aspergillosis: a report of six cases

Skin invasion by Aspergillus is infrequent. We here describe six immunocompromised patients with skin manifestations caused by Aspergillus. A heart transplant recipient developed a primary cutaneous aspergillosis; two patients (one with chronic granulomatous disease and another treated with a high dose of corticosteroids) presented with nodular lesions secondary to haematogenous dissemination; and three patients with acute myelogenous leukaemia had skin dissemination by contiguity from orbit and sinus invasion. A. flavus was isolated in the three cases of leukaemia; the infection was due to A. fumigatus in the transplant recipient; A. fumigatus and A. versicolor were isolated in the patients with the secondary aspergillosis. In most cases, amphotericin B was useful, with clinical and mycological remission in four patients. A patient with leukaemia died without undergoing treatment, and a child carrier of chronic granulomatous disease died after only 12 days of treatment.