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Chronic septal panniculitis caused by phaeohyphomycosis

C J Paredes1, E C Del Gordo, E Torrado

  • 1Resident II of Rheumatology, Uricersidad Na-cional de Colombia (CJP)

Journal of Clinical Rheumatology : Practical Reports on Rheumatic & Musculoskeletal Diseases
|December 17, 2008
PubMed

Insights

Panniculitis can be caused by fungal infections like Aureobasidium Pullulans phaeohyphomycosis. Early consideration of uncommon fungal causes is crucial for effective treatment of persistent panniculitis.

Area of Science:

  • Dermatology
  • Mycology
  • Infectious Diseases

Background:

  • Panniculitis presents as subcutaneous nodules, often linked to rheumatic diseases or infections.
  • Fungal infections, including Candida and Sporothrix, are known causes of panniculitis.
  • Phaeohyphomycosis is a group of fungal infections caused by dematiaceous fungi.

Purpose of the Study:

  • To report the first case of panniculitis caused by Aureobasidium Pullulans phaeohyphomycosis in an immunocompetent patient.
  • To highlight the importance of considering uncommon fungal pathogens in refractory panniculitis cases.

Main Methods:

  • A case study of an immunocompetent patient with chronic septal panniculitis.
  • Diagnostic evaluation including biopsy and identification of Aureobasidium Pullulans.
  • Treatment with a combination antifungal regimen.

Main Results:

  • Successful treatment of panniculitis caused by Aureobasidium Pullulans with amphotericin B, itraconazole, and flucytosine.
  • The patient showed an excellent response to the 4-week antifungal therapy.

Conclusions:

  • Aureobasidium Pullulans can cause panniculitis, even in immunocompetent individuals.
  • Phaeohyphomycosis should be considered in the differential diagnosis of chronic, treatment-resistant panniculitis with neutrophilic infiltrates.
  • Prompt identification and treatment of rare fungal infections are vital for managing panniculitis.

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