Cutaneous alternariosis: a rare chromohyphomycosis. Report of a case.

A 66-year-old woman presented 3 groups of scaly granulomatous lesions on the right forearm and elbow of six months duration. Direct examination of the scales showed hyphae and culture in lactrimel medium grew Alternaria sp. considered a contaminant. No improvement was observed after six months of treatment with oral griseofulvin. A second culture using half of a biopsy grew Alternaria sp. again and in histologic examination short pigmented fragments of hyphae surrounded by a granulomatous reaction were seen in the derma. The patient had marked improvement after treatment with erythromycin per os and miconazole topically; an atrophic scar remained as the only sign of the fungal infection.