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We report a case of cutaneous angioinvasive mucormycosis in which the fungi were also visualized on direct immunofluorescence. A 57\u2010year\u2010old patient with relapsed myelodysplastic syndrome status\u2010post allogeneic hematopoietic cell transplant, diabetes mellitus, and graft\u2010versus\u2010host disease presented with painful, palpable, dark\u2010red to violaceous retiform purpuric plaques. Light microscopy of punch biopsy revealed numerous broad, ribbon\u2010like, pauci\u2010septate hyphae in the dermis with angioinvasion, consistent with mucormycosis. Direct immunofluorescence performed on a concurrent biopsy to exclude immune complex vasculitis showed smooth IgG, IgA (weak), IgM (faint), and C3 deposition on the hyphal structures, compatible with antibody\u2010coated fungi. Tissue culture subsequently confirmed <jats:italic>Mucor<\/jats:italic> species. Although mucormycosis was readily diagnosable on routine light microscopy in this case, recognition of the unique phenomenon of antibody\u2010coated fungi can be crucial when the invasive fungi are sparse or only present in the direct immunofluorescence specimen.<\/jats:p>","DOI":"10.1111\/cup.14435","type":"journal-article","created":{"date-parts":[[2023,4,17]],"date-time":"2023-04-17T01:29:25Z","timestamp":1681694965000},"page":"637-641","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Detection of <scp>antibody\u2010coated<\/scp><i>Mucor<\/i> in skin biopsy by direct immunofluorescence"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7213-1040","authenticated-orcid":false,"given":"Ashley A.","family":"Brent","sequence":"first","affiliation":[{"name":"Department of Pathology, Michigan Medicine University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9323-8760","authenticated-orcid":false,"given":"Olivia","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Michigan Medicine University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milad","family":"Eshaq","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Michigan Medicine University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2359-8426","authenticated-orcid":false,"given":"Lori","family":"Lowe","sequence":"additional","affiliation":[{"name":"Department of Pathology, Michigan Medicine University of Michigan  Ann Arbor Michigan USA"},{"name":"Department of Dermatology, Michigan Medicine University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0650-1266","authenticated-orcid":false,"given":"May P.","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Pathology, Michigan Medicine University of Michigan  Ann Arbor Michigan USA"},{"name":"Department of Dermatology, Michigan Medicine University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,4,16]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijciis.ijciis_48_21"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmaid.2023.102557"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879\u2010022\u201007844\u2010y"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1590\/abd1806\u20104841.20176614"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2018.04.059"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/mmy\/myx101"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102334\u201014\u2010310"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir866"},{"key":"e_1_2_6_10_1","first-page":"721","volume-title":"Weedon's Skin Pathology","author":"Patterson J","year":"2021"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-7020-6830-0.50025-6"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1086\/432579"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/0031302031000123173"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00053\u201010"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir865"},{"key":"e_1_2_6_16_1","unstructured":"Thymoglobulin [package insert]. 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