title: A rare complication of ear piercing: a case of subcutaneous phaeohyphomycosis caused by Veronaea botryosa in China.
abstract: 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.
authors.affiliation: Department of Dermatology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
authors.forename: H
authors.initials: H
authors.lastname: Sang
authors.forename: X E
authors.initials: XE
authors.lastname: Zheng
authors.forename: Q T
authors.initials: QT
authors.lastname: Kong
authors.forename: W Q
authors.initials: WQ
authors.lastname: Zhou
authors.forename: W
authors.initials: W
authors.lastname: He
authors.forename: G X
authors.initials: GX
authors.lastname: Lv
authors.forename: Y N
authors.initials: YN
authors.lastname: Shen
authors.forename: W D
authors.initials: WD
authors.lastname: Liu
mesh_terms: 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
chemical_list: D000935:Antifungal Agents; D017964:Itraconazole