Dyschromia of hands and bronchial asthma caused by sooty molds.
Sooty molds are saprophytic fungi living on plants and feeding on honeydew secreted by some parasitic insects. We present a case of a 41-year-old male laborer who developed hypo- and hyperpigmented areas on his hands, without signs of inflammation or allergic reaction, together with several episodes of bronchial asthma, after occupational handling of sooty mold-covered citrus fruit. While positive prick tests to Alternaria (+++) and Cladosporium (+++) demonstrated the allergic nature of the patient's asthma, the pathogenic mechanism of skin dyspigmentation in such cases remains unknown. Hyperpigmentation could be due to intracutaneous penetration of a melanoid fungal pigment through repeated occupational microtraumatic events, while hypopigmentation could be caused by fungal products that are toxic/apoptosis-inducing for melanocytes and/or that interfere with melanogenesis (as observed for other fungi, such as Malassezia). This case suggests that further research is warranted in the probably underestimated field of sooty mold-related human diseases, and underlines the importance of education, use of protection devices, and prevention of sooty mold infestation in individuals exposed to these fungi.
Guarneri
Fabrizio
F
Institute of Dermatology, University of Messina, Messina, Italy. f.guarnieri@tiscali.it
Guarneri
Claudio
C
Cannavò
Serafinella Patrizia
SP
Guarneri
Biagio
B
D000328:Adult; D000528:Alternaria / Q000276:immunology*; D001249:Asthma / Q000276:immunology / Q000382:microbiology* / Q000628:therapy; D002963:Cladosporium / Q000276:immunology*; D003937:Diagnosis, Differential; D017575:Gloves, Protective; D006229:Hand Dermatoses / Q000276:immunology / Q000382:microbiology* / Q000628:therapy; D006801:Humans; D008297:Male; D009181:Mycoses / Q000150:complications* / Q000276:immunology / Q000628:therapy; D009784:Occupational Diseases / Q000276:immunology / Q000382:microbiology* / Q000628:therapy