Abstract:

Hu Suquan, Zhan Ping, Lyu Guixia, Mei Huan, Zeng Xuesi, Liu Weida Department of Mycology, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing 210042, China （Hu SQ, Lyu GX, Mei H, Liu WD）; Department of Pathology, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing 210042, China （Zeng XS）; Department of Mycology, Jiangxi Province Dermatosis Special Hospital, Nanchang 330000, China （Zhan P） Corresponding author: Liu Weida, Email: Liumyco@hotmail.com 【Abstract】 A 59-year-old female patient, who received bilateral lower limb amputation 39 years ago, presented with eczematoid changes in both lower limbs for over 20 years, and with chronic granuloma-like lesions complicated by verrucous hyperplasia for more than 10 years. There were large areas of infiltrative and proliferative lesions with exudation and peripheral erythema at the amputation sites in both knee joints. The lesions were hard with tenderness on palpation. Microscopic examination of lesional scales with 10% KOH showed negative results for fungi. However, three times of culture on the Sabouraud dextrose agar （SDA） medium all grew the same kind of fungus, and the front side and reverse side of its filamentous colony were white and orange yellow respectively. Microculture showed that linear hyaline conidiophores came out from lageniform mother cells with conidia ascending alongside. The conidia looked like dark brown eye lens, with an equatorial germ slit. Based on these findings, this fungus was identified as Arthrinium phaeospermum. Periodic acid-Schiff （PAS） staining showed scattered hyphae in the stratum corneum. The internal transcribe spacer （ITS） sequence of the isolated fungus showed 99% consistency with that of Arthrinium phaeospermum. The patient was diagnosed with cutaneous Arthrinium phaeospermum infection, and treated with oral itraconazole capsules 200 mg/d for 16 days. One month later, follow-up showed satisfactory outcomes.