2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T644,To emphasize the diagnostic value of cutaneous manifestations in disseminated invasive fungal disease (IFD). IFD carry high mortality and diagnosis is often delayed, while early recognition is crucial for patient outcomes. This review focuses on skin manifestations of fungi of highest relevance according to the WHO: Candida spp., Aspergillus spp., Mucorales, Fusarium spp., and Scedosporium spp. Cutaneous signs in disseminated candidiasis typically manifest as maculopapular or nodular lesions. Frequency and morphology vary depending on the Candida spp. involved. Secondary cutaneous aspergillosis presents with variable morphologies, including erythematous papules, ulcerative nodules, hemorrhagic bullae, or necrotic eschars, and may appear before standard diagnostic tests yield positive results. In invasive fusariosis, lesions typically present as vesicles or papules and progress to necrotic eschars. The morphology of skin manifestations of generalized mucormycosis varies according to the underlying disease. The formation of a necrotic eschar is considered pathognomonic. In disseminated scedosporiosis, cutaneous manifestations include ecchymoses, hemorrhagic bullae, necrotic papules, ulcers, or infiltrative plaques, often resembling infections with aspergillosis or fusariosis. Diagnosis requires a multimodal approach combining histopathology, microbiological cultures and nonculture-based assays. Despite the variability in frequency and presentation, cutaneous manifestations provide a valuable clinical clue in disseminated IFD and may facilitate early recognition and intervention.31:T9ff, Purpose of review To emphasize the diagnostic value of cutaneous manifestations in disseminated invasive fungal disease (IFD). IFD carry high mortality and diagnosis is often delayed, while early recognition is crucial for patient outcomes. This review focuses on skin manifestations of fungi of highest relevance according to the WHO: Candida spp., Aspergillus spp., Mucorales, Fusarium spp., and Scedosporium spp. Recent findings Cutaneous signs in disseminated candidiasis typically manifest as maculopapular or nodular lesions. Frequency and morphology vary depending on the Candida spp. involved. Secondary cutaneous aspergillosis presents with variable morphologies, including erythematous papules, ulcerative nodules, hemorrhagic bullae, or necrotic eschars, and may appear before standard diagnostic tests yield positive results. In invasive fusariosis, lesions typically present as vesicles or papules and progress to necrotic eschars. The morphology of skin manifestations of generalized mucormycosis varies according to the underlying disease. The formation of a necrotic eschar is considered pathognomonic. In disseminated scedosporiosis, cutaneous manifestations include ecchymoses, hemorrhagic bullae, necrotic papules, ulcers, or infiltrative plaques, often resembling infections with aspergillosis or fusariosis. Diagnosis requires a multimodal approach combining histopathology, microbiological cultures and nonculture-based assays. Summary Despite the variability in frequency and presentation, cutaneous manifestations provide a valuable clinical clue in disseminated IFD and may facilitate early recognition and intervention. 32:T845,The fungal diagnostic landscape is evolving; whereas previously, traditional culture-based methods dominated, most invasive fungal disease is now diagnosed with non-culture-based tests, including direct microscopy, antigen, antibody, and molecular assays, supported by histopathology and radiology. Access to and turnaround time of diagnostic tests and their clinical implementation varies across the UK. The British Society for Medical Mycology convened an expert group to update its 2015 best practice guidance. Guidance on histopathology and radiology investigations remain unchanged from the 2015 standards of care. For each mycological test, we include test-specific commentaries and accompanying tables, with expected turnaround times (sample collection to reporting). Based on recent evidence, new or stronger recommendations include use of Pneumocystis PCR; 1,3-β-D-glucan testing for suspected invasive candidiasis and Pneumocystis pneumonia; higher volume respiratory sample cultures; Aspergillus antigen or antibody-based testing in expanded clinically vulnerable populations, including patients in intensive care units and patients with chronic respiratory disease (including asthma); use of Candida PCR and Mucorales PCR in specific contexts; pan-fungal PCR and DNA sequencing for fungal identification from positive microscopy or histopathology specimens; and inclusion of posaconazole and isavuconazole in therapeutic antifungal monitoring recommendations. We discuss integration of diagnostic tests with antifungal stewardship and common clinical scenarios. Although recommendations focus on adults and UK practice, use in paediatric populations and worldwide applicability is discussed. Recommendations are presented as auditable standards to facilitate implementation and quality improvement measures. An emphasis on integration of combined diagnostics with antifungal stewardship and clinical pathways extends guideline relevance beyond microbiology laboratories to clinicians investigating patients with multimorbidity and suspected fungal disease within increasingly complex health-care systems.25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Aspergillosis: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Aspergillosis (condition). Clinician-written summaries and actionable practice insights. 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Level of evidence is set at 7 (expert opinion/consensus).","value_numeric":null}],"summaries":{"what_studied":"The Indian Fungal Infection National Declaration (I-FIND) evaluates the burden of serious fungal diseases in India — estimated to affect 4.1% of the population — and proposes a structured, time-bound national response across 9 core domains to reduce morbidity, mortality, and antifungal resistance.","key_result":"Mortality from invasive fungal diseases in India approaches 50%, surpassing several nationally prioritised conditions; key pathogens of concern include *Candidozyma auris*, azole-resistant *Aspergillus fumigatus*, and *Trichophyton indotineae*, with COVID-19-associated mucormycosis highlighting critical preparedness gaps.","limitations":"This is a consensus declaration rather than an original research study, so it does not present new primary data; burden estimates are derived from prior literature and may not capture current real-world epidemiology across all Indian regions.","practice_takeaway":"Clinicians should recognise fungal diseases — especially in immunocompromised, critically ill, chronic lung disease, and poorly controlled diabetic patients — as a major, under-prioritised public health threat in India. Proactive antifungal stewardship and early diagnostics are key actions supported by this declaration."}},{"doi":"10.1097/qco.0000000000001180","pmid":"41505800","title":"Skin signs of invasive fungal diseases: diagnostic clues for clinicians","journal_title":"Current Opinion in Infectious Diseases","journal_issn":"0951-7375","published_at":"2026-01-08T00:00:00.000Z","url":"https://doi.org/10.1097/qco.0000000000001180","source_score":20,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2026-01-13","doi":"10.1097/qco.0000000000001180","days":"7","issn":"0951-7375","rank":"6","field":"Clinical Medicine","score":"20","category":"Infectious Diseases","categories":["Infectious Diseases"],"_categories":["Infectious Diseases"]},"pubmed":{"doi":"10.1097/QCO.0000000000001180","title":"Skin signs of invasive fungal diseases: diagnostic clues for clinicians.","journal":"Current opinion in infectious 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Clinical Trials Centre Cologne (ZKS Köln), Faculty of Medicine, University of Cologne"}]},{"given":"Philipp","family":"Koehler","sequence":"additional","affiliation":[{"name":"Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Faculty of Medicine, University of Cologne"},{"name":"Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), European Confederation for Medical Mycology (ECMM) Excellence Center, University Hospital Cologne"},{"name":"Division of Clinical Immunology, Department I of Internal Medicine, University Hospital Cologne, Faculty of Medicine, University of Cologne and Center for Integrated Oncology (CIO) Aachen Bonn Cologne Duesseldorf, Cologne, Germany"}]},{"given":"Harald","family":"Seifert","sequence":"additional","affiliation":[{"name":"Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in 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outcome data are provided.","value_numeric":null},{"paper_doi":"10.1097/qco.0000000000001180","tag_type":"warning","value":"Some morphologies overlap between pathogens (e.g., scedosporiosis resembling aspergillosis or fusariosis), limiting specificity.","value_numeric":null}],"summaries":{"what_studied":"Review of cutaneous manifestations that signal disseminated invasive fungal disease, focusing on Candida spp., Aspergillus spp., Mucorales, Fusarium spp., and Scedosporium spp., and outlining a multimodal diagnostic approach.","key_result":"Characteristic patterns include: candidiasis—maculopapular or nodular lesions; aspergillosis—erythematous papules, ulcerative nodules, hemorrhagic bullae, or necrotic eschars that may precede standard test positivity; fusariosis—vesicles or papules progressing to necrotic eschars; mucormycosis—variable lesions with a necrotic eschar considered pathognomonic; scedosporiosis—ecchymoses, hemorrhagic bullae, necrotic papules, ulcers, or infiltrative plaques, often mimicking aspergillosis or fusariosis.","limitations":"Narrative review without quantitative data on lesion frequency or diagnostic accuracy. Scope limited to WHO-prioritized fungi; other pathogens are not addressed.","practice_takeaway":"In patients with suspected disseminated IFD, inspect the skin for these patterns—especially necrotic eschars—and pursue a multimodal workup with histopathology, culture, and nonculture-based assays. Recognize that skin lesions in aspergillosis may appear before standard tests turn positive, prompting earlier evaluation."}},{"doi":"10.1016/s1473-3099(25)00550-x","pmid":"41232547","title":"British Society for Medical Mycology best practice recommendations for the diagnosis of serious fungal diseases: 2025 update","journal_title":"The Lancet Infectious Diseases","journal_issn":"1473-3099","published_at":"2025-11-14T00:00:00.000Z","url":"https://doi.org/10.1016/s1473-3099(25)00550-x","source_score":112,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2025-12-02","doi":"10.1016/s1473-3099(25)00550-x","days":"30","issn":"1473-3099","rank":"4","field":"Clinical Medicine","score":"112","category":"Infectious Diseases","categories":["Infectious Diseases"],"_categories":["Infectious Diseases"]},"pubmed":{"doi":"10.1016/S1473-3099(25)00550-X","title":"British Society for Medical Mycology best practice recommendations for the diagnosis of serious fungal diseases: 2025 update.","journal":"The Lancet. 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microscopy or histopathology; include posaconazole and isavuconazole in therapeutic drug monitoring.","limitations":"Access to tests and turnaround times vary across the UK, which may limit implementation; recommendations focus on adults and UK practice, with pediatric and global applicability only discussed, not specified.","practice_takeaway":"Adopt non-culture diagnostics alongside stewardship: order Pneumocystis PCR and 1,3-β-D-glucan when PCP or invasive candidiasis is suspected; use higher-volume respiratory cultures; expand Aspergillus antigen/antibody testing to ICU and chronic lung disease; consider Candida and Mucorales PCR where appropriate; use pan-fungal PCR/sequencing when microscopy or histology is positive; monitor posaconazole and isavuconazole levels."}}],"initialOffset":3,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"condition","value":"Aspergillosis"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research 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