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November 1991

Squamous Cell Carcinoma Arising in Long-standing Granulomatous Hyalohyphomycosis Caused by Fusarium solani

Author Affiliations

Department of Dermatology Ehime University School of Medicine Shitsukawa Ehime 791-02, Japan; Department of Dermatology Osaka Police Hospital Osaka, Japan; Department of Medicine Faculty of Medicine Kyushu University Fukuoka, Japan

Arch Dermatol. 1991;127(11):1735-1737. doi:10.1001/archderm.1991.01680100139031

To the Editor.—  A 65-year-old Japanese woman was first seen in January 1979 because of a slowly enlarging, extensive, well-demarcated erythematous plaque on the right side of her face (Fig 1, panel A), which had started as a red papule 30 years before. No history of preceding trauma was offered. The general condition of this patient was not impaired. Her family history showed no apparent or chronic infections.Histologic examination of the lesion revealed an epithelioid cell granuloma with periodic acid-Schiff-positive fungal elements in the dermis. Based on the culture findings, a diagnosis of infection with Fusarium species was suggested, but could not be confirmed at the time.The patient was treated with oral griseofulvin and flucytosine with no favorable response. Topical 0.1% to 0.5% amphotericin-B injections were then tried weekly or monthly for 1 year, with partial regression of the plaque. The patient failed to appear for further

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