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Cutaneous alternariosis treated with miconazole
Archives of Dermatology
|May 1, 1981
Summary
A chronic knee skin infection caused by Alternaria sp. was treated. Topical miconazole nitrate successfully cleared the lesions after intravenous treatment failed.
Area of Science:
- Dermatology
- Mycology
- Infectious Diseases
Background:
- Chronic inflammatory skin conditions can present diagnostic challenges.
- Fungal infections, particularly those caused by dematiaceous molds like Alternaria, can be persistent.
Observation:
- A 40-year-old male presented with a decade-long, slowly progressing inflammatory skin lesion on his right knee.
- Biopsy culture identified the causative agent as Alternaria sp.
Findings:
- Antifungal susceptibility testing revealed high sensitivity to amphotericin B and miconazole nitrate.
- Intravenous miconazole nitrate (1.2 g daily for 31 days) was ineffective.
- Intralesional miconazole nitrate (10 mg in 10 mL Cremophor EL, twice weekly) resulted in lesion clearance over several months.
Implications:
- Topical or intralesional antifungal therapy may be a viable alternative for recalcitrant cutaneous Alternaria infections.
- This case highlights the importance of considering fungal etiologies in chronic skin inflammation.
- Local delivery of antifungals can overcome limitations of systemic administration.