Unusual Presentation of Subcutaneous Phaeohyphomycosis by Alternaria alternate

Area of Science:

• Mycology
• Dermatology
• Infectious Diseases

Background:

• Dematiaceous fungi, including Alternaria species, rarely cause human infections.
• Human infections are most commonly observed in immunocompromised individuals, particularly solid-organ transplantation recipients.
• Cutaneous alternariosis typically manifests as asymptomatic nodules, plaques, ulcers, or subcutaneous cysts.

Observation:

• A 77-year-old female presented with hemorrhagic skin necrosis on her right arm, originating from hemorrhagic bullae.
• The patient had a significant medical history including iatrogenic Cushing's syndrome, hypertension, interstitial lung disease, and congestive heart failure.

Findings:

• The patient's skin lesions showed improvement following treatment with itraconazole.
• This case represents an unusual presentation of cutaneous alternariosis.

Implications:

• This case expands the understanding of clinical presentations of Alternaria infections.
• Early diagnosis and appropriate antifungal therapy are crucial for managing rare fungal infections in vulnerable populations.
• Further research into Alternaria pathogenesis and treatment in non-immunocompromised or complex patient populations is warranted.