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Aspergillosis is a rare fungal infection, and primary cutaneous manifestations are particularly uncommon. The majority of cases occur in immunocompromised patients. Case presentation We report the case of a 14-year-old adolescent with diabetes who developed primary cutaneous aspergillosis after a stay in the intensive care unit due to decompensation of her condition. During her hospitalization, an ulceronecrotic papule appeared on the tip of her nose. Mycological analysis of the skin sample isolated and identified Aspergillus fumigatus. The clinical course was marked by hematogenous dissemination of the fungus, with cerebral involvement. The patient died of multiple organ failure. Conclusion The clinical lesions of primary cutaneous aspergillosis are nonspecific and generally present as various types of lesions, such as macules, papules, nodules, and pustules. This diversity and lack of specificity can lead to misdiagnosis and delayed treatment. Hematogenous dissemination, especially to distant sites such as the brain, is a particularly serious concern and should be promptly investigated in immunocompromised patients. Direct microscopy, microbiological culture, and histopathological examination are essential for establishing the diagnosis of primary cutaneous aspergillosis.