Primary cutaneous aspergillosis caused by Aspergillus.fumigatus in an immunocompetent patient

RATIONALE Primary cutaneous aspergillosis in immunocompromised patients has been well described in extensive investigations. However, in immunocompetent hosts, primary cutaneous infection of aspergillus occurs rarely, and remains poorly characterized. PATIENT CONCERNS We present a case of primary cutaneous aspergillosis manifested by erythematous plague covered with flava eschar. DIAGNOSES The patient was diagnosed with primary cutaneous aspergillosis. INTERVENTIONS Treatments with oral itraconazole at a dose of 75 mg/d and local wound care with ciclopirox olamine ointment were administered. OUTCOMES After half a month, a partial resolution and a decrease in tenderness indicated gradual improvement, and a complete remission was achieved 2 months later. LESSONS Primary cutaneous aspergillosis could occur in immunocompetent hosts. The initial lesions may appear in different forms, including macules, papules, nodules, or plaques. Repeated biopsy of a skin lesion for both culture and histopathology is needed.