Primary cutaneous mucormycosis: a diagnosis to consider

Primary cutaneous mucormycosis is a deep fungal infection, mainly seen in d iabetics and immunocompromised subjects. Rapid diagnosis and therapy are ne cessary to avoid fatal outcome. We describe the complete histopathological and microbiological studies of primary cutaneous mucormycosis in a 74-year- old man with several risk factors, such as chronic obstructive pulmonary di sease, respiratory acidosis, hemolytic anemia, myelodysplastic syndrome and iatrogenic diabetes, due to corticosteroid therapy. He developed two cutan eous necrotic scars on his left leg. Mucormycosis was suspected and specime ns from surgical debridement were histopathologically and microbiologically studied confirming the clinical diagnosis. Amphotericin B was given topica lly and intravenously resulting in complete healing of the ulcer. Risk fact ors and microbiological studies are compared with those in the current lite rature. It is necessary in certain cases to suspect mucormycosis infections in diabetics, immunocompromised subjects and even in healthy individuals. Rapid diagnosis and treatment are important, but they should be based on co mplete histopatholgical and microbiological studies, to establish the genus of the causal agent. (C) 1999 Elsevier Science B.V. All rights reserved.