Finger Abscess Caused by a Black Fungus, Exophiala xenobiotica

Exophiala xenobiotica is a relatively new species of black fungi that can cause infection that primarily affects the skin and soft tissues in humans. Black fungal infection is challenging to diagnose and often needs surgery. However, few studies have reported black fungal and E. xenobiotica infections in the field of plastic surgery. Herein, we report the case of a 79-year-old man who presented with a finger abscess, later identified via rDNA sequencing as E. xenobiotica infection. He did not have a history of immunosuppression. We resected the lesion and performed skin grafting. No recurrence was observed, even without antifungal medications. We compared this case with six previously reported cases and examined their similarities and differences. Surgical removal emerged as the most effective treatment option. Additional reports of successfully treated E. xenobiotica infections are needed to establish the best treatment strategy. Plastic surgeons should improve their awareness of black fungal infections.