Chromohyphomycosis. Treatment wit ketoconazole

Invasive chromoblastomycosis and sinusitis due to Phialophora verrucosa in a child from northern Africa

We report on a severe, verrucous facial mycosis and sinusitis in a 12-year-old Libyan girl. Her disease started with verrucous, hyperkeratotic plaques and subcutaneous violet nodules of unknown origin on her face and upper extremities. Despite topical antimycotic therapy she needed in-hospital treatment because of severely progressive tumorous cutaneous and nasal lesions. Microscopic examination of scale samples taken from the upper extremities and the face revealed brown, thick-walled fungal elements. Under the assumption of a chromoblastomycosis, an oral treatment with itraconazole and fluorocytosin was initiated, with significant improvement of the lesions. The aetiological agent was identified as Phialophora verrucosa.

Cutaneous phaeohyphomycosis caused by Exophiala jeanselmei after renal transplantation

A 60-year-old man who had had a renal transplantation developed a nodule on the dorsum of his right middle finger, which was subsequently diagnosed as cutaneous phaeohyphomycosis caused by Exophiala jeanselmei. The patient was successfully treated with 5-fluorocytosine. To our knowledge, this case is the third reported case in the world caused by this species in a postrenal transplant patient that manifested as phaeohyphomycosis.