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Mycologic evaluations in chronic leg ulcers.

Stefano Veraldi1, Anna Maria Tortorano, Luisa Lunardon

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Fungal superinfections are uncommon in chronic leg ulcers among non-diabetic patients. Mycologic examinations are likely unnecessary, as fungal presence did not alter ulcer appearance or response to antifungal therapy.

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Area of Science:

  • Medical Mycology
  • Dermatology
  • Infectious Diseases

Background:

  • Fungal superinfections in chronic leg ulcers are understudied, with limited and conflicting research.
  • Existing studies often involve small patient cohorts or single cases, hindering definitive conclusions.

Purpose of the Study:

  • To determine the prevalence of fungal superinfections in chronic leg ulcers.
  • To assess the clinical significance and impact of mycotic infections on ulcer management.

Main Methods:

  • A mycologic examination was performed on ulcers from 149 consecutive non-diabetic patients.
  • Two specimens were collected from each ulcer for fungal culture.

Main Results:

  • Fungal superinfections were identified in 7.4% of patients (11 out of 149).
  • Candida albicans was the most common isolate, followed by other Candida species. Molds and dermatophytes were not detected.
  • No distinct clinical features differentiated fungal superinfections, and oral antifungal treatment showed no improvement.

Conclusions:

  • Mycologic examination for fungal superinfections may not be necessary for non-diabetic patients with chronic leg ulcers.
  • The clinical impact of fungal superinfections in this patient group appears minimal.
  • Current antifungal treatment strategies may not be effective for managing fungal superinfections in chronic leg ulcers.