Cutaneous mycosis caused by Paecilomyces lilacinus

A 20-year-old woman had erythematous scaly plaques persistent for 15 years on the left cheek. Cultures from scales and biopsy specimens on Sabouraud's glucose agar repeatedly yielded floccose lilac colonies, and those on a Czapek's solution agar plate developed deep purplish red pigment, which is characteristic of Paecilomyces lilacinus. The PAS stain of the tissue section showed ovoid, divergent, or club-shaped fungal elements among the inflammatory cells or in giant cells. Two months after the patient and a control subject were inoculated with the isolates, P lilacinus could be reisolated from the patient only. Oral administration of griseofulvin significantly reduced erythema and papules. This is the first report, to our knowledge, of deep cutaneous mycosis caused by P lilacinus.