title: A suspected squamous cell carcinoma in a renal transplant recipient revealing a rare cutaneous phaeohyphomycosis by Alternaria infectoria.
abstract: BACKGROUND
  Squamous cell carcinoma of the skin is the most common neoplasm after organ transplantation. In addition, fungal infections are increasingly described in immunocompromised patients, such as kidney recipients.
  
  
  RESULTS
  We report a case of a 64-year-old woman with a renal transplant presenting with 6-month-old skin lesions. In other centers, she had undergone previous biopsies, the results of which were suggestive of squamous cell carcinoma and aspecific inflammation. Therefore, she came to our center for surgical excision. Only our clinical experience and a detailed clinical history allowed us to doubt previous diagnoses and perform further examinations. Our investigation revealed an extremely rare fungus infection: phaeohyphomycosis by Alternaria infectoria. It was successfully treated with oral terbinafine until a complete regression of the lesions was achieved. At a 16-month follow-up visit, no recurrence of the skin lesion was observed.
  
  
  CONCLUSIONS
  Despite a difficult diagnosis and rare occurrence, physicians and surgeons should be aware of infection with this emerging fungus in immunocompromised patients.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Catholic University of the Sacred Heart, University Hospital A. Gemelli, Rome, Italy. damtam@hotmail.it
authors.forename: Damiano
authors.initials: D
authors.lastname: Tambasco
authors.forename: Marco
authors.initials: M
authors.lastname: D'Ettorre
authors.forename: Roberto
authors.initials: R
authors.lastname: Bracaglia
authors.forename: Guido
authors.initials: G
authors.lastname: Massi
authors.forename: Brunella
authors.initials: B
authors.lastname: Posteraro
authors.forename: Riccardo
authors.initials: R
authors.lastname: Torelli
authors.forename: Clara
authors.initials: C
authors.lastname: De Simone
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Capizzi
mesh_terms: D000528:Alternaria / Q000302:isolation & purification*; D000935:Antifungal Agents / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D016030:Kidney Transplantation; D008875:Middle Aged; D009281:Naphthalenes / Q000627:therapeutic use*; D060446:Phaeohyphomycosis / Q000175:diagnosis* / Q000188:drug therapy* / Q000276:immunology / Q000382:microbiology; D012878:Skin Neoplasms / Q000175:diagnosis; D000077291:Terbinafine
chemical_list: D000935:Antifungal Agents; D009281:Naphthalenes; D000077291:Terbinafine