title: Spontaneous Remission of Subcutaneous Scedosporiosis Caused by Scedosporium dehoogii in a Psoriatic Patient.
abstract: To date, only one case of post-traumatic endophthalmitis caused by Scedosporium dehoogii has been reported, but its contamination or colonization might not be precluded due to the absence of pathogenic isolation and/or pathological examination. We report the first case to our knowledge of S. dehoogii-induced subcutaneous scedosporiosis in a psoriatic patient. A 58-year-old man with 5-year history of psoriasis vulgaris and immunosuppressant therapy developed pyrexia and multiple subcutaneous abscesses on both knees. Direct microscopy of the yellowish pus showed masses of bright green short spores. Skin biopsy revealed some branched septate hyphae within the granuloma. Two aspirated pus specimens collected at a 1-week interval produced white cottony colonies on Sabouraud dextrose agar. Bacterial cultures of one blood and two purulent samples were negative, and fungal culture of blood sample was not performed. The isolate was identified as S. dehoogii using β-tubulin phylogeny and species-specific PCR with primer MSDE1/MSA2. Without addition of antifungal treatment, subcutaneous lesions disappeared spontaneously after immunosuppressant withdrawal and no relapse occurred during 64-month follow-up. The spontaneous recovery may result from immune reconstitution following immunosuppressant discontinuation.
authors.affiliation: Department of Dermatology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524001, Guangdong, China.
authors.forename: Fang-Gu
authors.initials: FG
authors.lastname: Li
authors.affiliation: Department of Dermatology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524001, Guangdong, China.
authors.forename: Yan-Ping
authors.initials: YP
authors.lastname: Yang
authors.affiliation: Department of Dermatology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524001, Guangdong, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Dermatology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524001, Guangdong, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Sheng
authors.affiliation: Department of Dermatology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524001, Guangdong, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Dermatology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524001, Guangdong, China.
authors.forename: Wen-Ming
authors.initials: WM
authors.lastname: Huang
authors.affiliation: Department of Dermatology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524001, Guangdong, China. ymfan1963@163.com.
authors.forename: Yi-Ming
authors.initials: YM
authors.lastname: Fan
mesh_terms: D003881:Dermatomycoses / Q000175:diagnosis* / Q000473:pathology*; D006801:Humans; D008297:Male; D008828:Microbiological Techniques; D008853:Microscopy; D008875:Middle Aged; D010802:Phylogeny; D016133:Polymerase Chain Reaction; D011565:Psoriasis / Q000150:complications*; D012075:Remission, Spontaneous; D021681:Scedosporium / Q000302:isolation & purification*; D017422:Sequence Analysis, DNA; D014404:Tubulin / Q000235:genetics
chemical_list: D014404:Tubulin
keywords: PCR; Psoriasis; Scedosporiosis; Scedosporium dehoogii; β-Tubulin