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.