Avkan-Oğuz Vildan, Çelik Muammer, Satoglu Ismail S, Ergon Mahmut Cem, Açan Ahmet Emrah
Infectious Diseases and Clinical Microbiology, Dokuz Eylul University, School of Medicine, Izmir, TUR.
Orthopaedics and Traumatology, Dokuz Eylul University Faculty of Medicine, Izmir, TUR.
Cureus. 2020 Jan 8;12(1):e6600. doi: 10.7759/cureus.6600.
Primary cutaneous aspergillosis (PCA) can rarely affect immunocompetent people. There is limited knowledge about the prevalence, diagnosis and management of the disease because there are only case reports or small case series in the literature. For this reason, the diagnosis and treatment of three immunocompetent adult patients diagnosed with PCA were discussed by reviewing the literature. In the current report, in addition to treatment with voriconazole for 8-12 weeks we performed repeated surgical debridement for the treatment of these cases. After two negative tissue cultures, the wounds were either successfully closed primarily or reconstructed using a skin graft. Management of PCA cases will become easier as more reports and further studies of PCA contribute to our shared knowledge. Currently, the most appropriate management approach is to make individualized treatment decisions according to the patients' clinical features and treatment response which includes several surgical debridement as well as antifungal therapy.
原发性皮肤曲霉病（PCA）很少会影响免疫功能正常的人。由于文献中仅有病例报告或小病例系列，关于该疾病的患病率、诊断和管理的知识有限。因此，通过回顾文献讨论了三名被诊断为PCA的免疫功能正常成年患者的诊断和治疗。在本报告中，除了用伏立康唑治疗8 - 12周外，我们对这些病例进行了反复手术清创。在两次组织培养结果为阴性后，伤口要么一期成功闭合，要么使用皮肤移植进行重建。随着更多关于PCA的报告和进一步研究为我们的共同知识做出贡献，PCA病例的管理将变得更加容易。目前，最合适的管理方法是根据患者的临床特征和治疗反应做出个体化治疗决策，其中包括多次手术清创以及抗真菌治疗。
