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Dermatomykosen durch Fusarien

Skin infections caused by Fusarium

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Zusammenfassung

Unter begünstigenden Voraussetzungen können auch Schimmelpilze Infektionen der Haut verursachen. Fusarien gehören zu dieser Erregergruppe. Onychomykosen durch Fusarien kommen regelmäßig vor und lassen sich klinisch nicht von Dermatophyten-bedingten Nagelinfektionen unterscheiden. Sie können auch bei sonst Gesunden auftreten. An der Haut können Fusarien nekrotisierende, ulzerierende, pustulöse, vaskulitisartige, pannikulitisartige und granulomatöse Läsionen verursachen. Einzelne Läsionen können Folge einer Erregerinokulation in geschädigtes Gewebe sein, multiple sind oft Folge einer Fusariensepsis bei stark immungeschwächten Patienten. Eine sofortige Erregerdiagnostik kann in solchen Fällen lebensrettend sein. Pathogene Fusarien sollten auf Speziesebene identifiziert und auf ihre Antimykotikaempfindlichkeit getestet werden. Bei multiplen Läsionen ist eine systemische Therapie nach Antimykogramm angezeigt. Viele Fusarienstämme sind sensibel gegen Amphotericin B, Voriconazol und Posaconazol, Itraconazol und Terbinafin können im Einzelfall hilfreich sein.

Abstract

Under favorable conditions even molds can cause skin infections. Fusarium spp. belong to this group of agents. Onychomycoses due to Fusarium spp. are regularly encountered and cannot be clinically distinguished from nail infections triggered by dermatophytes. They can occur in otherwise healthy persons. Skin lesions caused by Fusarium spp. may be necrotizing, ulcerating, pustular, vasculitis-like, panniculitis-like or granulomatous. Single lesions can develop after fungal inoculation into damaged tissue; multiple ones are often due to a septic dissemination of Fusarium in severely immunocompromised patients. An immediate verification of the agents can be life-saving in such cases. Pathogenic Fusarium spp. should be identified at the species level and need to be tested for their susceptibility to antimycotics. In case of multiple lesions, systemic therapy is required. Many strains of Fusarium spp. are susceptible to amphotericin B, voriconazole and posaconazole; itraconazole and terbinafine may be helpful in certain cases.

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Literatur

  1. Arrese JE, Piérard-Franchimont C, Piérard GE (1996) Fatal hyalohyphomycosis following Fusarium onychomycosis in an immunocompromised patient. Am J Dermatopathol 18:196–198

    Article  PubMed  CAS  Google Scholar 

  2. Baran R, Tosti A, Piraccini BM (1997) Uncommon clinical patterns of Fusarium nail infection: report of three cases. Br J Dermatol 136:424–427

    Article  PubMed  CAS  Google Scholar 

  3. Baudraz-Rosselet F, Ruffieux C, Lurati M et al (2010) Onychomycosis insensitive to systemic terbinafine and azole treatments reveals non-dermatophyte moulds as infectious agents. Dermatology 220:164–168

    Article  PubMed  CAS  Google Scholar 

  4. Bourgeois GP, Cafardi JA, Sellheyer K et al (2010) Disseminated Fusarium infection originating from paronychia in a neutropenic patient: a case report and review of the literature. Cutis 85:191–194

    PubMed  Google Scholar 

  5. Brasch J, Beck-Jendroschek V, Wohlfeil E (2012) Chronische purulente Paronychie und Onychomykose durch Fusarium oxysporum. J Dtsch Dermatol Ges 10:519–520

    PubMed  Google Scholar 

  6. Brasch J, Köppl G (2009) Persisting onychomycosis caused by Fusarium solani in an immunocompetent patient. Mycoses 52:285–286

    Article  PubMed  CAS  Google Scholar 

  7. Brasch J, Shimanovich I (2012) Persistent fingernail onychomycosis caused by Fusarium proliferatum in a healthy woman. Mycoses 55:86–89

    Article  PubMed  CAS  Google Scholar 

  8. Bueno JG, Martinez C, Zapata B et al (2010) In vitro activity of fluconazole, itraconazole, voriconazole and terbinafine against fungi causing onychomycosis. Clin Exp Dermatol 35:658–663

    Article  PubMed  CAS  Google Scholar 

  9. Castro López N, Casas C, Sopo L et al (2009) Fusarium species detected in onychomycosis in Colombia. Mycoses 52:350–356

    Article  Google Scholar 

  10. Hoog GS de, Guarro J, Gené J, Figueras MJ (o J) Atlas of Clinical Fungi, electronic version 3.1; Centraalbureau voor Schimmelcultures, Utrecht, The Netherlands; Universitat Rovira i Virgili, Reus, Spain

  11. Dignani MC, Anaissie E (2004) Human fusariosis. Clin Microbiol Infect 10(Suppl 1):67–75

    Article  PubMed  Google Scholar 

  12. Gilaberte Y, Aspiroz C, Martes MP et al (2011) Treatment of refractory fingernail onychomycosis caused by nondermatophyte molds with methylaminolevulinate photodynamic therapy. J Am Acad Dermatol 65:669–671

    Article  PubMed  Google Scholar 

  13. Girmenia C, Arcese W, Micozzi A et al (1992) Onychomycosis as a possible origin of disseminated Fusarium solani infection in a patient with severe aplastic anemia. Clin Infect Dis 14:1167

    Article  PubMed  CAS  Google Scholar 

  14. Guilhermetti E, Takahachi G, Shinobu CS et al (2007) Fusarium spp. as agents of onychomycosis in immunocompetent hosts. Int J Dermatol 46:822–826

    Article  PubMed  CAS  Google Scholar 

  15. Gupta AK, Baran R, Summerbell RC (2000) Fusarium infections of the skin. Curr Opin Infect Dis 13:121–128

    Article  PubMed  Google Scholar 

  16. Hay RJ (2007) Fusarium infections of the skin. Curr Opin Infect Dis 20:115–117

    Article  PubMed  Google Scholar 

  17. Lurati M, Baudraz-Rosselet F, Vernez M et al (2011) Efficacious treatment of non-dermatophyte mould onychomycosis with topical amphotericin B. Dermatology 223:289–292

    Article  PubMed  CAS  Google Scholar 

  18. Lyon JP, Moreira LM, Moraes PC de et al (2011) Photodynamic therapy for pathogenic fungi. Mycoses 54:e265–271

    Article  PubMed  Google Scholar 

  19. Moreno G, Arenas R (2010) Other fungi causing onychomycosis. Clin Dermatol 28:160–163

    Article  PubMed  Google Scholar 

  20. Muhammed M, Coleman JJ, Carneiro HA et al (2011) The challenge of managing fusariosis. Virulence 2:91–96

    Article  PubMed  Google Scholar 

  21. Nakamura Y, Xu X, Saito Y et al (2007) Deep cutaneous infection by Fusarium solani in a healthy child: successful treatment with local heat therapy. J Am Acad Dermatol 56:873–877

    Article  PubMed  Google Scholar 

  22. Ninet B, Jan I, Bontems O, Léchenne B et al (2005) Molecular identification of Fusarium species in onychomycoses. Dermatology 210:21–25

    Article  PubMed  Google Scholar 

  23. Nucci M, Anaissie E (2007) Fusarium infections in immunocompromised patients. Clin Microbiol Rev 20:695–704

    Article  PubMed  CAS  Google Scholar 

  24. O’Donnell K, Sutton DA, Rinaldi MG et al (2010) Internet-accessible DNA sequence database for identifying fusaria from human and animal infections. J Clin Microbiol 48:3708–3718

    Article  Google Scholar 

  25. Ranawaka RR, Silva N de, Ragunathan RW (2008) Onychomycosis caused by Fusarium sp. in Sri Lanka: prevalence, clinical features and response to itraconazole pulse therapy in six cases. J Dermatolog Treat 19:308–312

    Article  PubMed  CAS  Google Scholar 

  26. Scheinfeld N (2007) A review of the new antifungals: posaconazole, micafungin, and anidulafungin. J Drugs Dermatol 6:1249–1251

    PubMed  Google Scholar 

  27. Sekhon AS, Padhye AA, Garg AK et al (1994) In vitro sensitivity of medically significant Fusarium species to various antimycotics. Chemotherapy 40:239–244

    Article  PubMed  CAS  Google Scholar 

  28. Seyfarth F, Hipler UC (2010) Fusarium als Verursacher dermatologischer Krankheitsbilder. Mycoses 53(Suppl 1):5–13

    Article  PubMed  Google Scholar 

  29. Trovato L, Rapisarda MF, Greco AM et al (2009) In vitro susceptibility of nondermatophyte molds isolated from onycomycosis to antifungal drugs. J Chemother 21:403–407

    PubMed  CAS  Google Scholar 

  30. Verrier J, Pronina M, Peter C et al (2012) Identification of infectious agents in onychomycoses by PCR-terminal restriction fragment length polymorphism. J Clin Microbiol 50:553–561

    Article  PubMed  CAS  Google Scholar 

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  1. Klinik für Dermatologie, Venerologie und Allergologie, UKSH, Campus Kiel, Schittenhelmstr. 7, 24105, Kiel, Deutschland

    J. Brasch

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Brasch, J. Dermatomykosen durch Fusarien. Hautarzt 63, 872–876 (2012). https://doi.org/10.1007/s00105-012-2382-3

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  • DOI: https://doi.org/10.1007/s00105-012-2382-3

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