Mohs micrographic surgery as an alternative treatment method for cutaneous mucormycosis.
BACKGROUND
Mucormycosis is an invasive fungal disease that most commonly occurs in immunocompromised patients. Early angioinvasion and dissemination can lead to the rapid demise of the patient. The growing number of organ transplant patients on pharmacologic immunosuppression has increased the risk for this opportunistic mycosis. Traditional therapy has included aggressive debridement and resection as well as antifungal medications.


OBJECTIVE
To demonstrate that the margin control and tissue-sparing technique of Mohs micrographic surgery can effectively eradicate mucormycosis infection and decrease morbidity.


METHODS
Case presentation of a 64-year-old transplant patient presenting with biopsy-proven cutaneous mucormycosis treated with Mohs micrographic surgery. Margin control was confirmed by a rapid Gomori methenamine silver stain.


RESULTS
There has been no recurrence at 1-year follow-up with full preservation of extremity function.


CONCLUSIONS
The use of the Mohs technique combined with rapid Gomori methenamine silver staining for mucormycosis can be an effective tissue-sparing method for local control of this fungal infection. Mohs micrographic surgery should be considered for the cutaneous manifestations of mucormycosis.
Clark
F Landon
FL
Department of Dermatology, Stanford University, Stanford, California 94305-5334, USA.
Batra
R Sonia
RS
Gladstone
Hayes B
HB
D003881:Dermatomycoses / Q000473:pathology / Q000601:surgery*; D005629:Frozen Sections; D006801:Humans; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery; D009091:Mucormycosis / Q000473:pathology / Q000601:surgery*; D009894:Opportunistic Infections / Q000473:pathology / Q000601:surgery*; D013194:Staining and Labeling