Faculty Collaboration Database

Angioinvasive fungal infections impacting the skin: Background, epidemiology, and clinical presentation. J Am Acad Dermatol 2019 Apr;80(4):869-880.e5

Date

08/14/2018

Pubmed ID

30102951

DOI

10.1016/j.jaad.2018.04.059

Scopus ID

2-s2.0-85062615002 (requires institutional sign-in at Scopus site)   55 Citations

Abstract

Angioinvasive fungal infections cause significant morbidity and mortality because of their propensity to invade blood vessel walls, resulting in catastrophic tissue ischemia, infarct, and necrosis. While occasionally seen in immunocompetent hosts, opportunistic fungi are emerging in immunosuppressed hosts, including patients with hematologic malignancy, AIDS, organ transplant, and poorly controlled diabetes mellitus. The widespread use of antifungal prophylaxis has led to an "arms race" of emerging fungal resistance patterns. As the at-risk population expands and new antifungal resistance patterns develop, it is critical for dermatologists to understand and recognize angioinvasive fungal pathogens, because they are often the first to encounter the cutaneous manifestations of these diseases. Rapid clinical recognition, histopathologic, and culture confirmation can help render a timely, accurate diagnosis to ensure immediate medical and surgical intervention. Superficial dermatophyte infections and deep fungal infections, such as blastomycosis and histoplasmosis, have been well characterized within the dermatologic literature, and therefore this article will focus on the severe infections acquired by angioinvasive fungal species, including an update on new and emerging pathogens. In the first article in this continuing medical education series, we review the epidemiology and cutaneous manifestations. The second article in the series focuses on diagnosis, treatment, and complications of these infections.

Author List

Shields BE, Rosenbach M, Brown-Joel Z, Berger AP, Ford BA, Wanat KA

Author

Karolyn A. Wanat MD Chair, Professor in the Dermatology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aspergillosis
Blood Vessels
Candidiasis, Cutaneous
Dermatomycoses
Drug Resistance, Fungal
Humans
Mucormycosis
Opportunistic Infections
Phaeohyphomycosis
Skin