Angioinvasive fungal infections impacting the skin: Background, epidemiology, and clinical presentation

Bridget E Shields; Misha Rosenbach; Zoe Brown-Joel; Anthony P Berger; Bradley A Ford; Karolyn A Wanat

doi:10.1016/j.jaad.2018.04.059

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Angioinvasive fungal infections impacting the skin: Background, epidemiology, and clinical presentation

Bridget E Shields, Misha Rosenbach, Zoe Brown-Joel, Anthony P Berger, Bradley A Ford and Karolyn A Wanat

Journal of the American Academy of Dermatology, Vol.80(4), pp.869-880.e5

04/2019

DOI: 10.1016/j.jaad.2018.04.059

PMID: 30102951

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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.

mucormycetes

Fusarium

Candidiasis

angioinvasive fungus

aspergillosis

Scedosporium

Details

Title: Subtitle: Angioinvasive fungal infections impacting the skin: Background, epidemiology, and clinical presentation
Creators: Bridget E Shields - Department of Dermatology, University of Wisconsin, Madison, Wisconsin
Misha Rosenbach - Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania
Zoe Brown-Joel - University of Iowa Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa
Anthony P Berger - Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
Bradley A Ford - Department of Pathology and Clinical Microbiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
Karolyn A Wanat - Department of Dermatology and Pathology, University of Iowa, Iowa City, Iowa. Electronic address: kwanat@gmail.com
Resource Type: Journal article
Publication Details: Journal of the American Academy of Dermatology, Vol.80(4), pp.869-880.e5
DOI: 10.1016/j.jaad.2018.04.059
PMID: 30102951
NLM abbreviation: J Am Acad Dermatol
ISSN: 0190-9622
eISSN: 1097-6787
Publisher: Elsevier Inc; United States
Grant note: DOI: 10.13039/100001582, name: Dermatology Foundation
Language: English
Date published: 04/2019
Academic Unit: Dermatology; Pathology
Record Identifier: 9984046909302771

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