A 28-year-old man, on immunosuppressive therapy for a recent kidney-pancreas transplant, presented to our department with an unusual violaceous nodule on his right knee. A biopsy specimen showed a granulomatous response in the dermis, surrounding numerous fungal cells and septate hyphae. Fungal cultures yielded dark grey colonies, which were identified as Alternaria tenuissima. To our knowledge this is the first report of A. tenuissima infection reported in the U.K.
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