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Dermatologic Manifestations of Aspergillosis Treatment & Management

  • Author: Annie Chiu, MD; Chief Editor: William D James, MD  more...
Updated: Aug 15, 2016

Medical Care

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.[12] 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.[13]

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.[5]


Surgical Care

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.

Contributor Information and Disclosures

Annie Chiu, MD Cosmetic and General Dermatologist

Annie Chiu, MD is a member of the following medical societies: American Academy of Dermatology, American Society for Dermatologic Surgery, Women's Dermatologic Society

Disclosure: Received consulting fee from Temptu for consulting; Received honoraria from Galderma for consulting; Received honoraria from SkinMedica for consulting.


Gabrielle E Wei Research Intern, Cedars Sinai Medical Center

Disclosure: Nothing to disclose.

Specialty Editor Board

David F Butler, MD Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic

David F Butler, MD is a member of the following medical societies: American Medical Association, Alpha Omega Alpha, Association of Military Dermatologists, American Academy of Dermatology, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Phi Beta Kappa

Disclosure: Nothing to disclose.

Jeffrey Meffert, MD Associate Clinical Professor of Dermatology, University of Texas School of Medicine at San Antonio

Jeffrey Meffert, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, Association of Military Dermatologists, Texas Dermatological Society

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.


Alexa F Boer Kimball, MD, MPH Associate Professor of Dermatology, Harvard University School of Medicine; Vice Chair, Department of Dermatology, Massachusetts General Hospital; Director of Clinical Unit for Research Trials in Skin (CURTIS), Department of Dermatology, Massachusetts General Hospital

Alexa F Boer Kimball, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Peter Fritsch, MD Chair, Department of Dermatology and Venereology, University of Innsbruck, Austria

Peter Fritsch, MD is a member of the following medical societies: American Dermatological Association, International Society of Pediatric Dermatology, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

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Primary cutaneous aspergillosis at a site of an intravenous catheter in a boy with leukemia.
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