Ulcerated plaque under a ruby ring in an immunosuppressed patient.

Area of Science:

• Mycology
• Infectious Diseases
• Hematology

Background:

• Acute myeloid leukemia (AML) patients have compromised immunity, increasing susceptibility to opportunistic infections.
• Fungal infections can manifest in various ways, sometimes associated with localized trauma or foreign bodies.

Observation:

• A 76-year-old man with AML developed a painful red plaque on his finger.
• The lesion's location corresponded to where he habitually wore a ruby ring.

Findings:

• Histopathology confirmed a fungal infection with multiple branching septate hyphae.
• Cultures isolated Fusarium species and Candida parapsilosis, indicating a primary inoculation fungal infection.

Implications:

• This case underscores the importance of considering unusual inoculation sites for fungal infections in immunocompromised individuals.
• Early recognition and appropriate antifungal therapy are crucial for managing such infections in patients with hematologic malignancies.