title: Fusariosis occurring in an ulcerated cutaneous CD8+ T cell lymphoma tumor.
abstract: Fusarium species have recently emerged as the second most common pathogenic mold in immunocompromised patients, and they are moderately resistant to most antifungal agents. The skin lesions of disseminated fusariosis typically manifest as multiple red or violaceous macules or nodules, often ulcerated and covered by a black eschar. We report a case of cutaneous fusariosis in a patient with long-standing hypopigmented mycosis fungoides. The infection was successfully treated with a 3-month course of oral voriconazole. The present case is unusual in that the infection occurred within a pre-existing, ulcerated lesion of cutaneous CD8+ lymphoma, resulting clinically in confusion with pyoderma gangrenosum and necrosis of lymphoma. A high index of suspicion will prompt a timely biopsy as well as isolation of the fungus, and early institution of systemic antifungal therapy.
authors.affiliation: Department of Dermatology, National Cheng Kung University Medical Center, Tainan, Taiwan.
authors.forename: Chao-Kai
authors.initials: CK
authors.lastname: Hsu
authors.forename: Mark Ming-Long
authors.initials: MM
authors.lastname: Hsu
authors.forename: Julia Yu-Yun
authors.initials: JY
authors.lastname: Lee
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use; D001483:Base Sequence; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology*; D017931:DNA Primers; D005670:Fusarium / Q000302:isolation & purification*; D006801:Humans; D016399:Lymphoma, T-Cell / Q000150:complications* / Q000000981:diagnostic imaging / Q000276:immunology; D009181:Mycoses / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000382:microbiology; D011743:Pyrimidines / Q000627:therapeutic use; D012878:Skin Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000276:immunology; D014057:Tomography, X-Ray Computed; D014230:Triazoles / Q000627:therapeutic use; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D017931:DNA Primers; D011743:Pyrimidines; D014230:Triazoles; D065819:Voriconazole