Voriconazole for the treatment of disseminated nodular cutaneous aspergillosis in a patient affected by acute myeloid leukemia.

We report a 44-year-old patient with refractory acute myeloid leukemia who developed a rare form of disseminated cutaneous aspergillosis resulting from colonization in the deep reticular dermis of Aspergillus flavus. Diagnosis was based on cutaneous biopsy. Antifungal therapy was started with liposomal amphotericin B (L AmB). However, the lesions continued to spread and there was a marked decline in the patient’s clinical condition. Consequently, L AmB was replaced with voriconazole. Response to voriconazole was excellent with regression of the skin lesions and a rapid improvement of the patient’s general clinical condition. The Hematology Journal (2004) 5, 178–180. doi:10.1038/sj.thj.6200341