To the Editor.—
In the January Archives Tschen et al1 described two fungal lesions associated with splinters, calling the lesions "chromomycosis." We believe, as do these authors, that chromomycosis probably begins when fungi of the dematiacious group are carried into the dermis by penetrating splinters or slivers. The two lesions they described, however—without getting mired down in definitions—more closely resemble phaeomycotic cyst2-4 than chromomycosis.5 The following clinicopathologic features support this: (1) clinically, the lesions of their patients lacked epidermal involvement; (2) histologically, the lesions lacked pseudoepitheliomatous hyperplasia characteristic of chromomycosis; (3) an inflammatory infiltrate characteristic of chromomycosis (both suppurative and granulomatous inflammation, with eosinophils, and concentrated in the upper dermis) was apparently not present; and (4) their patients' lesions contained obvious foreignbody splinters, a feature more characteristic of phaeomycotic cyst (eg, Figs 18,195). Finally, the pigmented fungi in their two lesions appear polymorphous, with pseudohyphae and
Connor DH, Gibson DW. Association of Splinters With Chromomycosis and Phaeomycotic Cyst. Arch Dermatol. 1985;121(2):168. doi:10.1001/archderm.1985.01660020026003
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