Dermatologic Manifestations of Aspergillosis Treatment & Management
- Author: Annie Chiu, MD; Chief Editor: William D James, MD more...
In both disseminated and limited cutaneous aspergillosis, high-dose intravenous amphotericin B, in traditional or liposomal form has been the traditional antifungal used to eradicate the underlying organism. However, voriconazole is also approved as a first-line agent for aspergillosis and is being used with increased frequency. Other treatment options for aspergillosis include itraconazole, caspofungin, or voriconazole in combination with terbinafine.[9, 10, 11] Topical voriconazole solution combined with a systemic antifungal has also been reported as effective for secondary cutaneous aspergillosis. For Aspergillus -induced onychomycosis, treatment is with oral itraconazole because topical medications have very limited efficacy in eradicating fungus from the nail.
From a more homeopathic standpoint, a recent study showed in vitro antifungal activity of essential oil of Juniperus communis against A flavus, A fumigatus, and A niger.
In the case of secondary wound infection of the scalp with A niger, treatment with ketoconazole 2% gel and retapamulin ointment resulted in resolution of the nonhealing wound.
Several case reports have documented the effectiveness of surgical excision or debridement in the treatment of primary cutaneous aspergillosis. Some of the patients also received concurrent or subsequent systemic antifungal therapy.
Consult a dermatologist for diagnosis, excision, and wound care.
Consult an infectious diseases specialist for treatment recommendations in the setting of systemic disease.
Laminar airflow protection and high-efficiency particulate air filters have been reported as effective ways to prevent nosocomial pulmonary aspergillosis in patients who are immunocompromised. To prevent primary cutaneous aspergillosis, use sterile dressings at catheter sites or other susceptible areas.
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