[Subcutaneous mycosis due to Scopulariopsis brevicaulis in an immunocompromised patient].
BACKGROUND
Scopulariopsis brevicaulis is a causal agent of onchomycosis. We report the unusual clinical manifestations caused by this opportunist fungus.


METHODS
A 61-year-old man consulted in February 1997 for a budding lesion located on the right medial malleolus. This patient had had a liver transplantation for primary biliary cirrhosis in 1990 and had been taking prednisone and cyclosporine since this time. Cyclosporine had been recently replaced by tacrolimus. The histology examination of a lesion specimen taken from the ankle evidenced a dermal mycosis due to opportunist filamentous fungus. Total excision was performed. The patient then developed nodular lesions of the left elbow during the summer of 1997. Mycology culture of a skin biopsy grew numerous colonies of Scopulariopsis brevicaulis. Excision of the elbow lesion was delayed due to hospitalization for suspected graft rejection and development of insulin-dependent diabetes. The elbow lesion was then resected followed by a skin graft. The mycology examination identified the same causal agent.


CONCLUSIONS
This liver transplant recipient developed two unusual extra-ungual localizations (ankle and elbow) of a Scopulariopsis brevicaulis infection. Chronic immunosuppression favored development of the infection with a pseudo-epithéliomatous presentation. The histology and mycology examinations were necessary for positive diagnosis.
Martel
J
J
2, rue Claude Martin, 73000 Chambéry.
Faisant
M
M
Lebeau
B
B
Pinel
C
C
Feray
C
C
Feuilhade
M
M
D001706:Biopsy; D016572:Cyclosporine / Q000009:adverse effects; D003881:Dermatomycoses / Q000139:chemically induced / Q000175:diagnosis* / Q000276:immunology / Q000382:microbiology* / Q000601:surgery; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects; D016031:Liver Transplantation / Q000276:immunology; D008297:Male; D008875:Middle Aged; D003904:Mitosporic Fungi; D009894:Opportunistic Infections / Q000139:chemically induced / Q000175:diagnosis* / Q000276:immunology / Q000382:microbiology* / Q000601:surgery; D011241:Prednisone / Q000009:adverse effects; D016559:Tacrolimus / Q000009:adverse effects
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D011241:Prednisone; D016559:Tacrolimus