ABSTRACT
Fungal infections comprise superficial and deep mycoses. Deep mycoses are classified as subcutaneous or the inoculation mycoses and the systemic mycoses, which in turn are further subdivided into systemic or the endemic mycoses and the opportunistic mycoses. Endemic mycoses have a predilection for a specific geographic area, with rare imported cases being reported after travel to an endemic area. Opportunistic mycoses are caused by saprophytic fungi with low pathogenicity, which may be nonpathogenic in immunocompetent individuals but produce severe infection in immunosuppressed patients, or by true pathogenic fungi, which become opportunistic in the background of immunosuppression. There has been a rise in the incidence of opportunistic mycoses worldwide, understandably due to the increase in the population of immunosuppressed patients due to solid organ and bone marrow transplantation, malignancies, uncontrolled diabetes mellitus, prolonged stay in intensive care units, invasive medical procedures, administration of broad-spectrum antibiotics, antineoplastic agents, newer immunosuppressive drugs, prolonged use of systemic corticosteroids, HIV infection, radiation therapy, use of artificial heart valves in cardiac surgeries, etc. Cutaneous manifestations of these invasive fungal infections act as a harbinger of the underlying systemic, life-threatening complications and help in early diagnosis and prompt institution of appropriate treatment, which in turn will help to reduce the morbidity of the patients. However, as the skin manifestations of deep mycoses could be highly varied and nonspecific, a high degree of clinical suspicion is essential. Opportunistic mold infections like mucormycosis, aspergillosis, fusariosis, and opportunistic yeast infections such as candidiasis and cryptococcosis are discussed.
