A rare complication of ear piercing: a case of subcutaneous phaeohyphomycosis caused by Veronaea botryosa in China.
We present the third case of phaeohyphomycosis caused by Veronaea botryosa in China and the tenth case worldwide. A 16-year-old Chinese girl developed crusted, verrucous lesions, initially on the left ear and later on the left buttock, within 2-5 months of receiving an ear piercing. Histopathological examination of biopsy specimens confirmed diagnosis of subcutaneous phaeohyphomycosis. Microscopic examination of the colonies recovered in culture from a portion of the biopsy specimen resulted in the identification of Veronaea botryosa based primarily on the presence of two-celled, brownish pigmented, cylindrical conidia produced sympodially from erect conidiogenous cells. The lesions significantly improved with daily oral treatment with itraconazole 400 mg and adjuvant thermotherapy for 6 months. A maintenance therapy with low dose itraconazole was prescribed in order to achieve clinical and mycological cure. A two-year follow-up didn't reveal any recurrence of infection. Our case is the first report of V. botryosa infection associated with a cosmetic procedure, which suggests that skin piercing could precipitate V. botryosa or other dematiaceous, as well as opportunistic fungal infections.
Sang
H
H
Department of Dermatology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
Zheng
X E
XE
Kong
Q T
QT
Zhou
W Q
WQ
He
W
W
Lv
G X
GX
Shen
Y N
YN
Liu
W D
WD
D000293:Adolescent; D000935:Antifungal Agents / Q000008:administration & dosage; D001203:Ascomycota / Q000302:isolation & purification*; D001706:Biopsy; D046288:Body Piercing / Q000009:adverse effects*; D002681:China; D005260:Female; D006651:Histocytochemistry; D006801:Humans; D006979:Hyperthermia, Induced; D017964:Itraconazole / Q000008:administration & dosage; D008853:Microscopy; D009181:Mycoses / Q000175:diagnosis* / Q000473:pathology* / Q000628:therapy; D040521:Subcutaneous Tissue / Q000473:pathology; D016896:Treatment Outcome
D000935:Antifungal Agents; D017964:Itraconazole