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October 1987

Subcutaneous Phaeohyphomycosis Caused by Exserohilum rostratum in an Immunocompetent Host

Author Affiliations

From the Departments of Dermatology (Drs Burges, Walls, and Maize) and Pathology (Drs Walls and Maize), Medical University of South Carolina, Charleston.

Arch Dermatol. 1987;123(10):1346-1350. doi:10.1001/archderm.1987.01660340108030

• A healthy, 55-year-old woman developed a subcutaneous abscess and systemic symptoms of nausea, dizziness, and chills following minor trauma to her leg. Histopathologic examination of a skin biopsy specimen revealed golden-brown colored mycelial elements, and culture resulted in growth of a dematiaceous fungus identified as Exserohilum rostratum. Surgical excision of the abscess and concomitant oral therapy with ketoconazole resulted in resolution of symptoms. In previously reported cases of human phaeohyphomycosis caused by Exserohilum and related Bipolaris species in both immunocompromised and immunocompetent hosts, treatment has varied from topical antimicrobial therapy to combined surgery and intravenous antifungal chemotherapy. Our experience leads us to believe that surgical débridement of an accessible focus of infection along with orally administered ketoconazole may provide adequate therapy in an immunocompetent host.

(Arch Dermatol 1987;123:1346-1350)