A Case of Cutaneous Alternariosis

Abstract

A six-year-old girl, a daughter of a farm house of melon, orage and tabacco, has suffered from a crusted erosion with erythema on her left cheek. The treatment was taken place two months later. The examination findings at the dermatology clinic of Shimabara Hospital, Nagasaki, the lesion consisted of a ∞-shaped, slightly elevated erythema with overlying scales (Fig. 1). Neither erosion nor pustules were recognized. Upon KOH-examination of the scale, frequently septated hyphae with irregular outline were found (Fig. 2) and Alternaria sp. was isolated on Sabouraud's glucose agar (Fig. 4-5). The lesion regressed spontaneously after two weeks, and left no scar. There have been reported occasional cases of cutaneous alternariosis in Japan (as summarized in the Table 1), Sweden, Switzerland and U. S. A. Their clinical feratures are, however, varied from superficial, transient form which is not so different from saprophytism, and intermediate form (cases of Nakama and Nishimoto) to deep-seated form with granulomatous tissue reaction fungal elements within it (cases of Kawasaki et al., Fukushiro et al. and Mikoshiba et al.). Differences in their responses to the treatments and in their prognoses among these three forms are also discussed.