Related Experiment Videos
Mohs micrographic surgery as an alternative treatment method for cutaneous mucormycosis
F Landon Clark1, R Sonia Batra, Hayes B Gladstone
1Department of Dermatology, Stanford University, Stanford, California 94305-5334, USA.
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.
Conclusion:
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.
Insights
Mohs micrographic surgery effectively treated cutaneous mucormycosis in an immunocompromised patient, preventing recurrence and preserving limb function. This tissue-sparing technique offers a promising option for managing this invasive fungal infection.
Area of Science:
- Dermatology
- Mycology
- Surgical Oncology
Background:
- Mucormycosis is a life-threatening invasive fungal infection, particularly in immunocompromised individuals like organ transplant recipients.
- Aggressive angioinvasion and dissemination characterize mucormycosis, often necessitating extensive surgical debridement and antifungal therapy.
- The rising prevalence of organ transplantation increases the incidence of opportunistic mucormycosis.
Observation:
- A 64-year-old organ transplant patient presented with biopsy-proven cutaneous mucormycosis.
- Mohs micrographic surgery was employed, utilizing rapid Gomori methenamine silver staining for precise margin control.
- The surgical technique focused on tissue preservation while ensuring complete eradication of the fungal infection.
Findings:
- The patient experienced no recurrence of mucormycosis at the 1-year follow-up.
- Full preservation of extremity function was achieved post-surgery.
- The Mohs technique demonstrated effective local control of the cutaneous fungal infection.
Implications:
- Mohs micrographic surgery, combined with rapid fungal staining, presents a viable tissue-sparing approach for cutaneous mucormycosis.
- This surgical modality should be strongly considered for managing the cutaneous manifestations of mucormycosis, especially in high-risk patients.
- The findings suggest a potential reduction in morbidity associated with mucormycosis treatment through meticulous surgical techniques.