Chromomycosis Associated with Myelodysplastic Syndrome Caused by <i>Exophiala jeanselmei</i>: A Review of Reported Cases of Dematiaceous Fungal Infection in Japan for the Recent 10 Years

Ishida Tadashi, Aota Noriko, Fukuda Tomoo

doi:10.14924/dermatol.119.1069

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骨髄異形成症候群に合併した<i>Exophiala jeanselmei</i>によるchromomycosisの1例：症例報告及び過去10年間における菌種別特徴
骨髄異形成症候群に合併したExophiala jeanselmeiによるchromomycosisの1例--症例報告及び過去10年間における菌種別特徴
コツズイイケイセイショウコウグンニガッペイシタ Exophiala jeanselmei ニヨル chromomycosis ノ 1レイショウレイホウコクオヨビカコ 10ネンカンニオケルキンシュベツトクチョウ

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A 71-year-old woman, who had been taking prednisolone to treat myelodysplastic syndrome until quite recently, visited our hospital with the complaint of a erythematous plaque with brownish-black crusts on her left leg. The eruption appeared over one year earlier. The topical application of a steroid ointment prescribed by a doctor was not effective. At first, we suspected chromomycosis, but it was ruled out due to repeatedly negative KOH direct microscopic examinations. Later, a biopsy revealed fungal elements at the deep zone of the dermis. On Sabouraud medium, colonies of Exophiala (E.) jeanselmei grew. We diagnosed chromomycosis caused by E. jeanselmei and treated her with oral administration of itraconazole for three months; the lesion disappeared completely. It is said that E. jeanselmei is less virulent and is associated with immunodeficiency. We validated these hypotheses with a review of reported cases of dematiaceous fungal infection in Japan for the recent 10 years. All the cases of chromomycosis caused by E. jeanselmei had occurred in compromised patients.

Journal

The Japanese Journal of Dermatology

The Japanese Journal of Dermatology 119 (6), 1069-1077, 2009

Japanese Dermatological Association

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