Invasive primary cutaneous phycomycosis in diabetic leg ulcers

Two cases of cutaneous phycomycosis in the form of diabetic leg ulcers were diagnosed by culture and biopsy demonstration of invasive fungal infection. The first patient had an infected vesicular skin lesion. Systemic amphotericin B therapy and repeated debridement were curative. A posttraumatic leg ulcer developed in the second patient in the setting of hyperglycemia and renal insufficiency. Aggressive infection necessitated a curative amputation. Phycomycetes can cause or complicate diabetic leg ulcers and such infections may require biopsy for early recognition and subsequent successful therapy.