[Subcutaneous phaeohyphomycosis due to Exophiala spinifera in a renal transplant recipient].
BACKGROUND
Among the dematiaceous fungi responsible for human or animal phaeohyphomycosis, the Exophiala genus is a well-known etiologic agent and presently includes nine species considered as opportunist pathogens. To our knowledge, Exophiala spinifera has been reported as causative agent of only thirteen cases of cutaneous or systemic phaeohyphomycosis. We describe some typical phaeohyphomycotic cysts.


METHODS
A 59 year-old female renal transplant recipient, treated with ciclosporine and prednisone, presented with two painless nodular and suppurative lesions of the leg, extending slowly. Histological and microbiological examinations identified Exophiala spinifera. The patient's condition improved with voriconazole treatment.


CONCLUSIONS
Phaeohyphomycosis is a rare but cosmopolitan mycosis found throughout the world. Immunocompromised hosts are more vulnerable to these infections and more likely to develop severe and disseminated forms of uncertain outcome. Mycological and histological findings are important to confirm the diagnosis. The prognosis is benign and complete cure is common in cutaneous and superficial forms. Treatment is not well defined, often empirical and usually relies on antifungals and/or complete surgical resection.
Dutriaux
C
C
Service de Dermatologie, CHU de Fort-de-France, Martinique.
Saint-Cyr
I
I
Desbois
N
N
Calès-Quist
D
D
Diedhou
A
A
Boisseau-Garsaud
A-M
AM
D000935:Antifungal Agents / Q000627:therapeutic use; D016572:Cyclosporine / Q000627:therapeutic use; D005093:Exophiala / Q000302:isolation & purification / Q000472:pathogenicity*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects*; D007866:Leg / Q000382:microbiology / Q000473:pathology; D008875:Middle Aged; D009181:Mycoses / Q000209:etiology*; D011241:Prednisone / Q000627:therapeutic use; D011743:Pyrimidines / Q000627:therapeutic use; D014230:Triazoles / Q000627:therapeutic use; D065819:Voriconazole
D000935:Antifungal Agents; D007166:Immunosuppressive Agents; D011743:Pyrimidines; D014230:Triazoles; D016572:Cyclosporine; D065819:Voriconazole; D011241:Prednisone