{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T19:51:46Z","timestamp":1789588306340,"version":"build-2803163510"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T00:00:00Z","timestamp":1742256000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Primary subcutaneous mycoses are a heterogeneous group of fungal infections caused by pathogenic or opportunistic organisms. In recent years, cases have steadily increased in Shanghai, an area where the disease was previously uncommon. This study aimed to summarize clinical experiences with primary subcutaneous mycoses in Shanghai, to optimize their management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A retrospective analysis was conducted at Shanghai Dermatology Hospital from January 2018 to March 2023 and enrolled 33 patients with confirmed primary subcutaneous mycoses. Their medical histories, clinical features, histopathological findings, etiological characteristics, drug sensitivity tests, therapeutic regimens, and follow-up data were recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Identification of pathogens from skin tissue cultures revealed distinct colonial morphologies across diverse mycological species. The isolates included yeast (45.5%), mold (30.3%), and dimorphic fungi (24.2%). The most common species were <jats:italic>C. parapsilosis<\/jats:italic> (n = 8, 24.2%), <jats:italic>T. rubrum<\/jats:italic> (n = 5, 15.2%), and <jats:italic>S. schenckii<\/jats:italic> (n = 8, 24.2%). Thirty-two patients received systemic antifungal treatment based on the results of the drug sensitivity test, whereas one patient was treated with complete surgical resection, owing to a single plaque. Post-treatment surveillance was important for the effective management of the condition.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study highlights the considerable diversity among fungal species implicated in primary cutaneous mycoses and underscores the complexities involved in their accurate diagnosis and management. Correcting unhealthy lifestyles, boosting immunity, and completely removing and avoiding re-exposure to the pathogenic fungi can effectively reduce the risk of relapse in primary subcutaneous mycoses. Our findings provide valuable insights into primary subcutaneous mycoses and may contribute to improved patient prognoses.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcimb.2025.1520608","type":"journal-article","created":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T07:03:09Z","timestamp":1742281389000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Clinical experience of primary subcutaneous mycoses in Shanghai: a retrospective analysis"],"prefix":"10.3389","volume":"15","author":[{"given":"Qian","family":"Yu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lulu","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanyuan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiqin","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siyu","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingwen","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoping","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lianjuan","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,3,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1016\/j.clindermatol.2011.09.006","article-title":"Classification of subcutaneous and systemic mycoses","volume":"30","author":"Arenas","year":"2012","journal-title":"Clin. Dermatol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"633","DOI":"10.1128\/CMR.00007-11","article-title":"Sporothrix schenckii and sporotrichosis","volume":"24","author":"Barros","year":"2011","journal-title":"Clin. Microbiol. Rev."},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1093\/mmy\/myae001","article-title":"Deep cutaneous mycoses in kidney transplant recipients: diagnostic and therapeutic challenges","volume":"62","author":"Bertin","year":"2024","journal-title":"Med. Mycol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1111\/j.1610-0387.2010.07453","article-title":"Subcutaneous mycoses: chromoblastomycosis, sporotrichosis and mycetoma","volume":"8","author":"Bonifaz","year":"2010","journal-title":"JDDG"},{"key":"B5","doi-asserted-by":"publisher","first-page":"801","DOI":"10.1016\/j.jaad.2021.04.007","article-title":"JAAD game changers: diagnosis of deep cutaneous fungal infections: correlation between skin tissue culture and histopathology","volume":"85","author":"Brodell","year":"2021","journal-title":"J. Am. Acad. Dermatol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"165rv13","DOI":"10.1126\/scitranslmed.3004404","article-title":"4:165rv13. Hidden killers: human fungal infections","volume":"4","author":"Brown","year":"2012","journal-title":"Sci. Transl. Med."},{"key":"B7","doi-asserted-by":"publisher","first-page":"806","DOI":"10.1016\/j.ad.2016.05.017","article-title":"Cutaneous involvement in the deep mycoses: a literature review. Part I-Subcutaneous Mycoses","volume":"107","author":"Carrasco-Zuber","year":"2016","journal-title":"Actas Dermosifiliogr."},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.4081\/dr.2023.9782","article-title":"Deep mycosis mimicking cutaneous squamous cell carcinoma","volume":"16","author":"Cassalia","year":"2023","journal-title":"Dermatol. Rep."},{"key":"B9","doi-asserted-by":"publisher","first-page":"146","DOI":"10.12788\/j.sder.0112","article-title":"Subcutaneous (deep) fungal infections","volume":"33","author":"Elgart","year":"2014","journal-title":"Semin. Cutan. Med. Surg."},{"key":"B10","doi-asserted-by":"publisher","first-page":"3533","DOI":"10.1128\/AAC.02060-15","article-title":"High intracellular concentrations of posaconazole do not impact on functional capacities of human polymorphonuclear neutrophils and monocyte-derived macrophages in vitro. Antimicrob","volume":"60","author":"Farowski","year":"2016","journal-title":"Agents Chemother."},{"key":"B11","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1016\/j.idc.2023.05.001","article-title":"Emerging diagnostics and therapeutics for invasive fungal infections","volume":"37","author":"Friedman","year":"2023","journal-title":"Infect. Dis. Clin. North Am."},{"key":"B12","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1016\/j.jaad.2014.03.042","article-title":"Diagnosis of deep cutaneous fungal infections: correlation between skin tissue culture and histopathology","volume":"71","author":"Gonzalez Santiago","year":"2014","journal-title":"J. Am. Acad. Dermatol."},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1093\/mmy\/myab062","article-title":"Chromoblastomycosis in Latin America and the Caribbean: Epidemiology over the past 50 years","volume":"60","author":"Guevara","year":"2021","journal-title":"Med. Mycol."},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.3390\/jof9030322","article-title":"Implantation mycoses and invasive fungal infections with cutaneous involvement in tropical Taiwan: an 11-year retrospective study of a medical center","volume":"9","author":"Hsu","year":"2023","journal-title":"J. Fungi (Basel)"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2022.1021837","article-title":"CARD9 in host immunity to fungal, bacterial, viral, and parasitic infections: an update","volume":"13","author":"Hu","year":"2022","journal-title":"Front. Microbiol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"697","DOI":"10.1007\/s40257-017-0276-y","article-title":"A unique clinicopathological manifestation of fungal infection: a case series of deep dermatophytosis in immunosuppressed patients","volume":"18","author":"Kershenovich","year":"2017","journal-title":"Am. J. Clin. Dermatol."},{"key":"B17","doi-asserted-by":"publisher","first-page":"962","DOI":"10.1111\/1346-8138.12968","article-title":"Epidemiology of deep cutaneous fungal infections in Korea, (2006\u20132010)","volume":"42","author":"Kim","year":"2015","journal-title":"J. Dermatol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1111\/j.1439-0507.2012.02191.x","article-title":"Clinical analysis of deep cutaneous mycoses: a 12-year experience at a single institution","volume":"55","author":"Kim","year":"2012","journal-title":"Mycoses"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1044","DOI":"10.1093\/mmy\/myaa018","article-title":"Deep fungal infections diagnosed by histology in Uganda: a 70-year retrospective study","volume":"58","author":"Kwizera","year":"2020","journal-title":"Med. Mycol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"530","DOI":"10.1007\/s11908-012-0275-3","article-title":"Subcutaneous fungal infections","volume":"14","author":"La Hoz","year":"2012","journal-title":"Curr. Infect. Dis. Rep."},{"key":"B21","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1016\/0196-4399(91)90038-W","article-title":"Recent developments in antifungal susceptibility testing","volume":"13","author":"LaRocco","year":"1991","journal-title":"Clin. Microbiol. Newsl."},{"key":"B22","doi-asserted-by":"publisher","first-page":"180","DOI":"10.21037\/atm-23-448","article-title":"Difference analysis of cutaneous sporotrichosis between different regions in China: a secondary analysis based on published studies on sporotrichosis in China","volume":"11","author":"Li","year":"2023","journal-title":"Ann. Transl. Med."},{"key":"B23","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1093\/mmy\/myw006","article-title":"Sporothrix schenckii complex in Iran: Molecular identification and antifungal susceptibility","volume":"54","author":"Mahmoudi","year":"2016","journal-title":"Med. Mycol."},{"key":"B24","doi-asserted-by":"publisher","first-page":"J15","DOI":"10.3314\/mmj.56.J15","article-title":"Dermatomycoses and medically important fungi that are necessary subjects of study for dermatology specialists \u2013 a personal experience","volume":"56","author":"Nishikawa","year":"2015","journal-title":"Med. Mycol. J."},{"key":"B25","volume-title":"Reference Method for Broth Dilution Antifungal Susceptibility Testing of Filamentous Fungi. 3rd ed. CLSI standard M38","author":"Pa","year":"2017"},{"key":"B26","doi-asserted-by":"publisher","first-page":"1101","DOI":"10.1086\/651262","article-title":"Invasive fungal infections among organ transplant recipients: results of the Transplant-Associated Infection Surveillance Network (TRANSNET)","volume":"50","author":"Pappas","year":"2010","journal-title":"Clin. Infect. Dis."},{"key":"B27","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1080\/13693780802538001","article-title":"Chromoblastomycosis: an overview of clinical manifestations, diagnosis and treatment","volume":"47","author":"Queiroz-Telles","year":"2009","journal-title":"Med. Mycol."},{"key":"B28","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1016\/S0891-5520(02)00066-1","article-title":"Subcutaneous mycoses","volume":"17","author":"Queiroz-Telles","year":"2003","journal-title":"Infect. Dis. Clin. North Am."},{"key":"B29","doi-asserted-by":"publisher","first-page":"560","DOI":"10.1016\/j.eimc.2011.10.018","article-title":"Invasive fungal disease: conventional or molecular mycological diagnosis","volume":"30","author":"Quind\u00f3s","year":"2012","journal-title":"Enferm. Infecc. Microbiol. Clin."},{"key":"B30","doi-asserted-by":"publisher","first-page":"e02409","DOI":"10.1128\/AAC.02409-18","article-title":"Antifungal drugs influence neutrophil effector functions","volume":"63","author":"Ries","year":"2019","journal-title":"Antimicrob. Agents Chemother."},{"key":"B31","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1097\/QCO.0000000000000870","article-title":"Mycetoma, chromoblastomycosis and other deep fungal infections: diagnostic and treatment approach","volume":"35","author":"Seas","year":"2022","journal-title":"Curr. Opin. Infect. Dis."},{"key":"B32","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1016\/j.mmcr.2023.02.001","article-title":"Deep dermatophytosis in an immunocompetent adult with no prior history of skin disease","volume":"39","author":"Simonsen","year":"2023","journal-title":"Med. Mycol. Case Rep."},{"key":"B33","doi-asserted-by":"publisher","first-page":"328","DOI":"10.1111\/j.1399-0012.2009.01071.x","article-title":"Incidence and clinical predictors of primary opportunistic deep cutaneous mycoses in solid organ transplant recipients: a multicenter cohort study","volume":"24","author":"Tessari","year":"2010","journal-title":"Clin. Transpl."},{"key":"B34","doi-asserted-by":"publisher","first-page":"623","DOI":"10.1111\/ijd.13497","article-title":"Cutaneous manifestations of subcutaneous and systemic fungal infections in tropical regions: A retrospective study from a referral center in southern Taiwan","volume":"56","author":"Tsai","year":"2017","journal-title":"Int. J. Dermatol."},{"key":"B35","doi-asserted-by":"publisher","first-page":"283","DOI":"10.3109\/10408410903213393","article-title":"Candida parapsilosis: a review of its epidemiology, pathogenesis, clinical aspects, typing and antimicrobial susceptibility","volume":"35","author":"van Asbeck","year":"2009","journal-title":"Crit. Rev. Microbiol."},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms10051010","article-title":"Invasive and subcutaneous infections caused by filamentous fungi: report from a Portuguese multicentric surveillance program","volume":"10","author":"Ver\u00edssimo","year":"2022","journal-title":"Microorganisms"},{"key":"B37","volume-title":"Reference Method for Broth Dilution Antifungal Susceptibility Testing of Yeasts","author":"Wayne","year":"2017"}],"container-title":["Frontiers in Cellular and Infection Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2025.1520608\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T07:03:13Z","timestamp":1742281393000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2025.1520608\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,18]]},"references-count":37,"alternative-id":["10.3389\/fcimb.2025.1520608"],"URL":"https:\/\/doi.org\/10.3389\/fcimb.2025.1520608","relation":{},"ISSN":["2235-2988"],"issn-type":[{"value":"2235-2988","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,18]]},"article-number":"1520608"}}