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Observational Studies

Diagnostic Findings of Invasive Cutaneous Fungal Infections: A Retrospective Study

Abstract

INTRODUCTION: The diagnosis of invasive cutaneous fungal infections is challenging, with delayed diagnosis potentially leading to worsened outcomes for patients. Current gold standard techniques of culture and histopathology are limited by poor sensitivity.

METHODS: We retrospectively reviewed all inpatient dermatology consultations from 2017-2020 with confirmed invasive fungal infections by histopathologic and/or tissue culture identification of fungal organisms. Tissue specimens were obtained via 4-millimeter punch biopsies of skin lesions. Microscopic examination of slides was performed by a board-certified dermatopathologist.

RESULTS: Twenty-three cases were identified, with 18 demonstrating classic histopathologic features of invasive fungal infection and five demonstrating atypical features or focal findings limited to the base of the biopsies. In two cases, features of leukemia/lymphoma cutis obscured findings of an infectious etiology.

CONCLUSIONS: Histopathologic evidence of invasive cutaneous fungal infections may be focal and limited to deeper sections of skin, as well as obscured by a separate processes. Performance of deeper biopsies may improve diagnostic yield and capture previously missed cases of invasive cutaneous fungal infection.

Keywords: inpatient dermatology, cutaneous infection, fungal, mycosis, immunocompromised

How to Cite:

Nusbaum, K. B., Nusbaum, K., Awethe, Z., McGrath, M., Kaffenberger, B. H., Trinidad, J., Spaccarelli, N. & Chung, C. G., (2026) “Diagnostic Findings of Invasive Cutaneous Fungal Infections: A Retrospective Study”, Academic Dermatology 4(1), 1-8. doi: https://doi.org/10.18061/ad.5820

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Authors

  • Kelsey B. Nusbaum (The Ohio State University College of Medicine)
  • Kelsey Nusbaum
  • Zaynah Awethe (The Ohio State University College of Medicine)
  • Mary McGrath (The Ohio State University College of Medicine)
  • Benjamin H. Kaffenberger (The Ohio State University College of Medicine)
  • John Trinidad (The Ohio State University College of Medicine)
  • Natalie Spaccarelli (The Ohio State University College of Medicine)
  • Catherine G. Chung (The Ohio State University College of Medicine, The Ohio State University Wexner Medical Center)

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