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Bipolaris spicifera is a dematiaceous fungus that has rarely been reported to cause cutaneous infection in humans. A patient with leukemia was examined for a non-healing ulcer on her leg that developed following minor trauma. Histopathologic study revealed groups of nonpigmented, septate fungal hyphae located predominantly in the necrotic ulcer base. Cultures of a biopsy specimen yielded colonies that were gray to black with a black reverse. Microscopic examination revealed dematiaceous, straight, oblong conidia consistent with B spicifera. The ulcer was successfully treated with surgical excision, skin graft, and amphotericin B.

A 45-year-old white woman was referred to the department of dermatology for evaluation of asymptomatic lesions on her right lower leg. The lesions had first appeared approximately 8 years earlier and had remained unchanged. The patient denied fever or constitutional symptoms. Her other medical problems included rheumatoid arthritis and type II diabetes mellitus.The findings of the physical examination revealed approximately 20 discrete, 4-to 6-mm firm, nontender, erythematous, blanchable papules on the anterolateral aspect of the right leg below the knee (Figs 1 and 2). The surface of the lesions appeared normal. A 4-mm punch skin biopsy specimen was obtained (Figs 3 and 4).

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