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Arch Dermatol. 2007;143(12):1583-1588.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Diagnosis: Cutaneous alternariosis.

MICROSCOPIC FINDINGS AND CLINICAL COURSE

Histologic analysis of the biopsy specimen showed a hyperplastic epidermis with a granulomatous reaction (Figure 2). High-power examination revealed large intracellular yeasts (10-15µm in diameter) in the dermis (Figure 3, arrows). Skin culture findings demonstrated Alternaria species Alternaria alternata.

Figure appears in full text version. Figure 2.

Figure appears in full text version. Figure 3.

The patient was prescribed oral voriconazole, 150 mg/d. She was admitted to hospital 10 days later with a severe toxic reaction to tacrolimus, resulting in vomiting, hypocalcaemia, and deterioration in renal function. This was attributed to the systemic antifungal therapy because voriconazole increases serum tacrolimus concentrations. Her treatment was changed to itraconazole, 400 mg/d, with no further problems. Surgical excision was considered, but there was considerable clinical improvement with systemic treatment after 3 months. There was complete resolution of the nodule after 5 months.

DISCUSSION

Alternaria species are common plant pathogens but are a rare cause of human infection. An altered host resistance . . . [Full Text of this Article]

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Arch Dermatol. 2007;143(12):1583-1588.
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