Alternaria alternata 피부 감염 1예
A Case of Cutaneous Infection by Alternaria alternata
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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 beenreported, 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 multipleerythematous papules, plaque and pustules with purpuric patches on both forearms and dorsal hands for6 months. He had been treated for Parkinson's disease and dementia for 3 years but had not been takingany immunosuppressants. Direct smear with KOH was negative. Histopatholoigically, neutrophilicabscess, suppurative granulomatous inflammation and round spores were observed in the dermis. Periodicacid-Schiff and Methenamine silver stains revealed round to oval shaped spores. The biopsy specimenwas cultured in potato dextrose agar and a cottony olive green to gray colored colony with black to brownreverse grew at 7 days of culture. The slide culture stained with lactophenol-cotton blue showed brownseptated hyphae and obclavate conidia with brown muriform septation. The nucleotide sequences of theribosomal internal transcribed spacer region of cultured colonies and paraffin blocks of biopsy specimenwere identical to that of A. alternata. He was treated with topical ketoconazole cream application for 4months, and healed leaving hyperpigmentation with scales.
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 beenreported, 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 multipleerythematous papules, plaque and pustules with purpuric patches on both forearms and dorsal hands for6 months. He had been treated for Parkinson's disease and dementia for 3 years but had not been takingany immunosuppressants. Direct smear with KOH was negative. Histopatholoigically, neutrophilicabscess, suppurative granulomatous inflammation and round spores were observed in the dermis. Periodicacid-Schiff and Methenamine silver stains revealed round to oval shaped spores. The biopsy specimenwas cultured in potato dextrose agar and a cottony olive green to gray colored colony with black to brownreverse grew at 7 days of culture. The slide culture stained with lactophenol-cotton blue showed brownseptated hyphae and obclavate conidia with brown muriform septation. The nucleotide sequences of theribosomal internal transcribed spacer region of cultured colonies and paraffin blocks of biopsy specimenwere identical to that of A. alternata. He was treated with topical ketoconazole cream application for 4months, and healed leaving hyperpigmentation with scales.
참고문헌 (19)
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