Endemic deep or systemic mycoses are common in specific geographical areas of the world. Coccidioidomycosis is present in semi-desert areas, histoplasmosis and paracoccidioidomycosis in tropical regions and blastomycosis belongs to temperate climates. The two former are widely distributed in the American continent and some tropical regions of the world; the third is limited to Central and South America, and the last to North America and Central and East Africa. These mycoses all have a similar pathogenesis, as the inoculum enters the host through the respiratory tract. Cutaneous manifestations are secondary to lymphatic and hematogenous dissemination. These deep mycoses are exceptional in Europe. Most cases are observed in returning travelers from endemic areas, aid workers, archaeologists, speleologist and immigrants. However, there have been some autochthonous cases of histoplasmosis due to Histoplasma capsulatum var. capsulatum reported in European countries such as Italy and Germany. In this article, we provide up-to-date epidemiological, clinical, diagnostic and therapeutic data on the four most important imported systemic mycoses in Europe.

Subcutaneous mycoses are common in subtropical and tropical regions of the world. They are rarely observed in Europe. These mycoses are heterogeneous, but all are caused by penetrating trauma of the skin. Most cases in Europe are observed in returning travelers, aid workers, archaeologists and immigrants. Therefore, a careful, thorough history is essential in order to reach a proper diagnosis. We provide up-to-date epidemiological, clinical, diagnostic, and therapeutic data on the three most important imported subcutaneous mycoses in Europe: chromoblastomycosis, sporotrichosis and mycetoma.

Summary Opportunistic yeast infections are diseases caused by fungi which normally are saprophytic and do not cause disease in humans or animals. The prevalence of these diseases has been increasing due to immunosuppressive, corticosteroid, and long‐term antibiotic treatment following organ transplantation or after serious metabolic, hematological, or immunological diseases. We review epidemiological, clinical, diagnostic, and therapeutic aspects of the four “big” opportunistic yeast infections: candidiasis, cryptococcosis, trichosporonosis, and geotrichosis.

Zusammenfassung Ichthyosen sind seltene genetische Hautkrankheiten, die den Kliniker vor mannigfache Herausforderungen stellen, insbesondere in Bezug auf das Stellen einer zutreffenden Diagnose und einer angemessenen therapeutischen Betreuung. Mit dieser Aktualisierung der deutschen Ichthyosis‐Leitlinie berücksichtigen wir jüngste diagnostische Fortschritte, die in die Konsensus‐Klassifikation von Sorèze mündeten und erarbeiten einen aktuellen Diagnose‐Algorithmus, der sowohl das klinische Bild als auch die Molekulargenetik dieser Erkrankungen berücksichtigt. Darüber hinaus wird der heutige Wissensstand bezüglich therapeutischer Ansätze wie psychosozialer Unterstützung, Balneotherapie, mechanischer Schuppenlösung, topischer Salbentherapie und Systemtherapie mit Retinoiden erläutert und es werden allgemeine Aspekte wie die Indikation für Physiotherapie, Ergotherapie oder die Notwendigkeit einer umfassenden genetischen Beratung diskutiert. Diese Aktualisierung der deutschen Ichthyosis‐Leitlinie wurde durch eine interdisziplinär besetzte Leitlinienkonferenz verabschiedet, an der Dermatologen, Kinderärzte, Humangenetiker und Naturwissenschaftler teilnahmen und in die die deutsche Patientenorganisation Selbsthilfe Ichthyose e. V. eingebunden war.

Summary Opportunistic filamentous mycoses are widely distributed all over the world. They are rarely observed in Europe but are common in developing countries. The most common are the aspergilloses (due to Aspergillus spp.) mostly in neutropenia and immunosuppression; the mucormycoses characterized by rapid progression in patients with diabetic ketoacidosis; the phaeohyphomycoses due to pigmented fungi causing either a mild superficial or a very serious deep disease and the hyalohyphomycoses due to hyaline filamentous fungi (Fusarium spp., Pseudallescheria spp., Scopulariopsis spp.). Cutaneous manifestations are usually secondary to dissemination from pulmonary or visceral disease; primary cases are less frequent and due to direct inoculation into the skin. We review epidemiological, clinical, diagnostic, and therapeutic data on the four most important opportunistic filamentous mycoses: aspergillosis, mucormycosis, phaeohyphomycosis and hyalohyphomycosis.