Primary cutaneous phaeohyphomycosis: report of seven cases

Ronan, Salve G.; Uzoaru, Ikechukwu; Nadimpalli, Venkat; Guitart, Joan; Manaligod, José R.

doi:10.1111/j.1600-0560.1993.tb00647.x

Cited by 50 publications

(41 citation statements)

References 12 publications

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“…Terbinafine has also been used successfully, particularly in patients failing azole therapy (7). Surgical excision alone has been successful in a number of cases, even in organ transplant patients (12,194,235,387,418,558,587,646,686,720,764). The Mohs surgical technique, which was developed for removing melanoma, may be a useful surgical approach, as it spares tissue and completely removes the pathological lesion in staged surgeries (86).…”

Section: Phaeohyphomycosismentioning

confidence: 99%

“…and Phialophora spp. are the next most common fungi, followed by Cladosporium spp., Exserohilum spp., Veronaea botryosa, and many others with scattered case reports (7,12,19,23,32,36,56,61,65,81,140,143,194,209,230,241,251,258,306,313,342,362,365,369,387,413,418,421,457,469,482,486,487,495,539,559,556,568,571,576,590,609,613,614,646,659,694,699,720,728,…”

Section: Phaeohyphomycosismentioning

confidence: 99%

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Melanized Fungi in Human Disease

2010

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SUMMARY Melanized or dematiaceous fungi are associated with a wide variety of infectious syndromes. Many are soil organisms and are generally distributed worldwide, though certain species appear to have restricted geographic ranges. Though they are uncommon causes of disease, melanized fungi have been increasingly recognized as important pathogens, with most reports occurring in the past 20 years. The spectrum of diseases with which they are associated has also broadened and includes allergic disease, superficial and deep local infections, pneumonia, brain abscess, and disseminated infection. For some infections in immunocompetent individuals, such as allergic fungal sinusitis and brain abscess, they are among the most common etiologic fungi. Melanin is a likely virulence factor for these fungi. Diagnosis relies on careful microscopic and pathological examination, as well as clinical assessment of the patient, as these fungi are often considered contaminants. Therapy varies depending upon the clinical syndrome. Local infection may be cured with excision alone, while systemic disease is often refractory to therapy. Triazoles such as voriconazole, posaconazole, and itraconazole have the most consistent in vitro activity. Further studies are needed to better understand the pathogenesis and optimal treatment of these uncommon infections.

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Section: Phaeohyphomycosismentioning

confidence: 99%

Section: Phaeohyphomycosismentioning

confidence: 99%

Melanized Fungi in Human Disease

2010

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“…The differential diagnosis of subcutaneous PHM includes lipomas, epidermal cysts and foreign body granuloma 4. Skin biopsy may show neutrophil-rich abscesses and granulomatous inflammation with histiocytes, lymphocytes and multinucleated giant cells 9. As in our case, a thorn or wooden splinter along with a foreign body granulomatous reaction can be observed.…”

Section: Discussionmentioning

confidence: 50%

Surgical management of subcutaneousColletotrichum gloeosporioides

Allton

Parvez²,

Ranganath

et al. 2015

BMJ Case Reports

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A 52-year-old male patient with a history of sarcoidosis and over 10 years of chronic low-dose glucocorticoid use, cirrhosis and type 2 diabetes mellitus presented with two painful, enlarging subcutaneous nodules ultimately identified as Colletotrichum gloeosporioides. Two attempts at needle aspiration of the larger nodule resulted in rapid reaccumulation. Complete surgical excision of both nodules resulted in complete resolution without the use of any concomitant antifungals. Patient had no recurrence at 2 years of follow-up.

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“…19,20 Cutaneous infection with phaeohyphomycoses, although rare, has also been reported in the literature in cases of immunosuppressed patients. [21][22][23] However, the above case is the only published report of a patient E. longirostratum was identified in this patient's cutaneous lesions through diagnostic biopsy, using microscopic and culture evaluation of tissue sample. Because the patient had idiopathic thrombocytopenia and microvascular thrombosis of lesion specimens, a vasculitis with associated cutaneous ulceration and secondary superinfection needs to be considered in the patient's differential diagnosis.…”

Section: Discussionmentioning

confidence: 72%

Rare Lower Extremity Invasive Fungal Infection in an Immunosuppressed Patient: Exserohilum longirostratum

Al-Attar

Williams²,

Redett³

2006

Plastic and Reconstructive Surgery

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A 68-year-old immunosuppressed man presented with multiple ulcers and cellulitis on his right lower extremity. The patient was in good health until 6 months before admission, when routine screening revealed idiopathic thrombocytopenia with splenomegaly. The idiopathic thrombocytopenia was immediately treated with systemic steroids. After initiation of steroid therapy, the patient developed multiple ulcers circumferentially on his right lower extremity that later became cellulitic. Initiation of systemic steroid therapy in this patient was also complicated by diabetes mellitus and activation of chronic hepatitis C that contributed to cirrhosis and hepatic encephalopathy. At the time of examination, the patient was being evaluated for liver transplantation, and was assessed as Child's class B with a MELD score of 17.At the time of consultation for his lower extremity wounds, the patient's medications included oral prednisone. He was being treated with systemic voriconazole and Flagyl for a presumed polymicrobial infection of his lower extremity ulcers that had previously been unresponsive to systemic ciprofloxacin and gatifloxacin.Lower extremity examination revealed multiple well-demarcated ulcers on his right anterior and lateral lower leg (Fig. 1). The ulcers were dry and escharous and ranged in maximal diameter from 1 to 4 cm. Erythema surrounded the ulcers but without clear demarcation. Neither leg was excessively warm to touch. Neither purulence nor odor was noted. Dorsalis pedis and posterior tibial pulses were palpable bilaterally. Moderate edema was present bilaterally, and there was minimal brownish discoloration over both anterior tibial regions. The patient did not exhibit any sensory or motor deficits in his lower extremities, although movement resulted in lower extremity pain.Laboratory studies revealed severe thrombocytopenia and anemia with a mildly elevated white blood cell count. Tests for autoimmune markers including erythrocyte sedimentation rate, perinuclear antineutrophil cytoplasmic antibody, cytoplasmic antineutrophil cytoplasmic antibody, and cryoglobulins in the patient's serum were negative.Lower extremity computed tomographic scans did not find any evidence of fluid collections, subcutaneous gas, bony destruction, or periosteal reaction but did show moderate subcutaneous edema. Diagnostic skin biopsy specimens of the lower extremity ulcers and surrounding regions demonstrated diseased vasculature with thrombi in vessels along with focal necrosis, interstitial inflammation, and microabscesses. Microscopic examination also revealed multiple fungal elements. Biopsy cultures grew Escherichia coli, methicillin-resistant Staphylococcus aureus, and heavy fungal elements on all plates. The fungus was speciated as Exserohilum longirostratum that was sensitive to voriconazole; no other fungi were isolated. During his hospital course, the patient's lower extremity infection progressed and developed worsening ulcerations despite treatment with systemic antifungal therapy and local oxychlorosene-base...

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Primary cutaneous phaeohyphomycosis: report of seven cases

Cited by 50 publications

References 12 publications

Melanized Fungi in Human Disease

Melanized Fungi in Human Disease

Surgical management of subcutaneousColletotrichum gloeosporioides

Rare Lower Extremity Invasive Fungal Infection in an Immunosuppressed Patient: Exserohilum longirostratum

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