Background  Aspergillus species are widely distributed in nature; however, cutaneous infections due to A. terreus are particularly rare. In this report, we describe a very uncommon case of primary cutaneous aspergillosis presenting as cauliflower-like skin lesions caused by A. terreus in a patient with preexisting bilateral filarial elephantiasis of the legs.

Materials and methods  Histopathological examination of the lesions revealed narrow, septate, branching, acute-angled hyphae with delicate chitinous walls and multinucleated giant cells in the dermis.

Results  The fungal isolate was identified as A. terreus using standard laboratory procedures.

Conclusion  Here we report an extremely rare and unusual manifestation of primary cutaneous aspergillosis.