Mycologic evaluations in chronic leg ulcers

Thus far, the role of fungi in superinfection of chronic leg ulcers has been poorly studied. Many articles are based on either a small number of patients or single cases. Furthermore, the study conclusions are conflicting. Objective. The objective of this study was to evaluate the percentage of mycotic superinfections and their clinical importance in chronic leg ulcers. Methods. A group of 149 consecutive patients without diabetes was subjected to mycologic examination of the ulcers. Two specimens were obtained from each ulcer. Results. Mycologic examinations were positive in 11 patients (7.4%). Candida albicans was the most frequently isolated species (7 patients), followed by C. parapsilosis (2 patients), C. krusei (1 patient), C. parapsilosis and C. lipolytica (1 patient). Neither dermatophytes nor molds were isolated. No particular features characterized the clinical appearance of ulcers superinfected by fungi, and no clinical improvement of ulcers with mycotic superinfections was observed with oral antimycotic therapy. Conclusion. Based on the results of this study, mycologic examinations may be considered unnecessary in patients without diabetes who suffer with chronic leg ulcers