Cutaneous alternariosis

A 77-year-old woman had had a slowly spreading lesion of five years' duration on her left cheek. The lesion consisted of sharply demarcated, dark-red plaques with infiltration. A biopsy specimen from the lesion showed mixed-cell granulomatous infiltration in the upper to middle dermis. Hyphae were observed in the granulomatous tissue. Alternaria tenuissima was isolated from a biopsy specimen. Antimycotic susceptibility test with amphotericin B, ketoconazole, and flucytosine revealed that the isolate was sensitive to the former two drugs. The lesion was treated with intralesional infiltration of amphotericin B.