Korean J Med Mycol.  2014 Sep;19(3):76-81.

A Case of Cutaneous Infection by Alternaria alternata

Affiliations
  • 1Department of Dermatology, College of Medicine, Yeungnam University, Daegu, Korea. jschoi@med.yu.ac.kr

Abstract

Alternaria(A.) species are common saprophyte found in the environment such as soil, air, and plants. They are not usually pathogenic in humans but recently, infections by these fungi have occasionally been reported, occurring mostly in immunocompromised patients. They can cause hypersensitivity pneumonitis, bronchial asthma, or allergic rhinitis and rarely skin infection. A 76-year-old man presented with multiple erythematous papules, plaque and pustules with purpuric patches on both forearms and dorsal hands for 6 months. He had been treated for Parkinson's disease and dementia for 3 years but had not been taking any immunosuppressants. Direct smear with KOH was negative. Histopatholoigically, neutrophilic abscess, suppurative granulomatous inflammation and round spores were observed in the dermis. Periodic acid-Schiff and Methenamine silver stains revealed round to oval shaped spores. The biopsy specimen was cultured in potato dextrose agar and a cottony olive green to gray colored colony with black to brown reverse grew at 7 days of culture. The slide culture stained with lactophenol-cotton blue showed brown septated hyphae and obclavate conidia with brown muriform septation. The nucleotide sequences of the ribosomal internal transcribed spacer region of cultured colonies and paraffin blocks of biopsy specimen were identical to that of A. alternata. He was treated with topical ketoconazole cream application for 4 months, and healed leaving hyperpigmentation with scales.

Keyword

Alternaria alternata; Cutaneous alternariosis; Ketoconazole

MeSH Terms

Abscess
Agar
Aged
Alternaria*
Alternariosis
Alveolitis, Extrinsic Allergic
Asthma
Base Sequence
Biopsy
Coloring Agents
Dementia
Dermis
Forearm
Fungi
Glucose
Hand
Humans
Hyperpigmentation
Hyphae
Immunocompromised Host
Immunosuppressive Agents
Inflammation
Ketoconazole
Methenamine
Neutrophils
Olea
Paraffin
Parkinson Disease
Rhinitis
Skin
Soil
Solanum tuberosum
Spores
Spores, Fungal
Weights and Measures
Agar
Coloring Agents
Glucose
Immunosuppressive Agents
Ketoconazole
Methenamine
Paraffin
Soil
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