title: Multifocal subcutaneous phaeohyphomycosis caused by Phialophora verrucosa.
abstract: An otherwise healthy 85-year-old woman presented with purulent multifocal subcutaneous nodules on the dorsal side of the right forearm and hand. Histopathologic examination of the biopsied specimen showed a subcutaneous granuloma with central abscess and necrosis, consistent with phaeomycotic cyst. Faint brown septate hyphae and moniliform fungal elements were found in the granuloma. Culture of the discharge grew Phialophora verrucosa. This fungus has rarely been reported as a pathogen of subcutaneous phaeohyphomycosis. Subcutaneous phaeohyphomycosis usually presents as a single lesion. In this case of multifocal lesions, initial imperfect excision seems to have caused satellite lesions. To our knowledge, this is the first report of multifocal subcutaneous phaeohyphomycosis caused by P verrucosa. The disease responded to oral itraconazole administration.
authors.affiliation: Second Department of Pathology, Kinki University School of Medicine, Osaka-Sayama, Japan. kimura-m@med.kindai.ac.jp
authors.forename: Masatomo
authors.initials: M
authors.lastname: Kimura
authors.forename: Akio
authors.initials: A
authors.lastname: Goto
authors.forename: Tomoko
authors.initials: T
authors.lastname: Furuta
authors.forename: Takao
authors.initials: T
authors.lastname: Satou
authors.forename: Shigeo
authors.initials: S
authors.lastname: Hashimoto
authors.forename: Kazuko
authors.initials: K
authors.lastname: Nishimura
mesh_terms: D000368:Aged; D003560:Cysts / Q000382:microbiology / Q000473:pathology; D003881:Dermatomycoses / Q000382:microbiology* / Q000473:pathology*; D005260:Female; D006099:Granuloma / Q000382:microbiology* / Q000473:pathology; D006801:Humans; D025301:Hyphae / Q000302:isolation & purification; D010676:Phialophora / Q000302:isolation & purification*; D040521:Subcutaneous Tissue / Q000382:microbiology / Q000473:pathology