Aspergillus Genus and Its Various Human Superficial and Cutaneous Features

Abstract

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.

Keywords: Aspergillus; burns; cutaneous; onychomycosis; otomycosis; trauma.

Figure 1

Etiological factors of superficial and cutaneous aspergillosis.

Figure 2

(a) Clinical appearance of self-induced otomycosis in a schizophrenic patient; (b) macroscopic aspect of Aspergillus flavus.

Figure 3

(a) Aspergillus onychomycosis induced by trauma in a vegetable vendor patient; (b) Aspergillus flavus culture macroscopy.