Cutaneous phaeohyphomycosis due to Cladophialophora bantiana

We present a case of cutaneous infection due to Cladophialophora bantiana, an agent of phaeohyphomycosis. The patient developed a nodule with pustule formation on the dorsum of the left hand; no trauma was reported. The lesion was successfully treated with itraconazole and surgical excision. Histopathologically, there was a blastomycosis-like tissue reaction pattern. Pigmented organisms were readily identified in tissue sections, and the cultural characteristics were those of Cladophialophora bantiana. This organism, known primarily for intracerebral involvement, can rarely produce cutaneous and subcutaneous infection. Immunosuppression should be suspected but is not always clinically apparent, as was demonstrated by our case.