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A case of hyperpigmentation distributed in streaks and whorls was recently delineated and separated from a confusing number of pigmentary disorders. A 13-year-old boy had hyperpigmented, reticulate spots on his trunk and neck in a linear and whorled distribution following the lines of Blaschko. Onset was at age 1 year. Histologically, the spots showed increased melanin in the basal layer of the epidermis, but no increase in melanocytes, incontinence of pigment, or melanophages were seen in the dermis. The karyotype was 46,XY and there was no evidence of chromosomal mosaicism or chimerism. This entity represents a disorder separated recently from other pigmentary alterations that follow Blaschko lines, such as Bloch-Sulzberger incontinentia pigmenti, hypomelanosis of Ito, early systematized epidermal nevus, and chimerism.

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A 42-year-old woman presented with a well-defined pruritic erythematous scaly plaque on the sole of each foot. The lesions, first noted about 15 years previously, were located in the medial plantar region and extended laterally. Mycological study revealed infection by Scopulariopsis brevicaulis. Treatment with oral itraconazole led to temporary improvement, but the symptoms returned after treatment had been stopped (presumably due to re-infection from ungual foci). Similar results were subsequently obtained with oral terbinafine. S. brevicaulis is an aetiologic agent of onychomycosis, panophthalmia following a penetrating eye injury and generalized infections in immunocompromised patients, but it is not considered as habitual fungal pathogen of the skin. Cutaneous lesions caused by S. brevicaulis are very rare. Our case was resistant to terbinafine and itracomazole.