Abstract
Paecilomyces, a hyalohyphomycosis, is an uncommon cause of cutaneous and subcutaneous infections. Most cases reported have occurred in patients with impaired host defenses or following a surgical procedure, and have proven highly resistant to anti fungal therapies. A 60‐year‐old man presented with scattered non‐healing verrucous lesions as well as ulcers and excoriations on the upper extremities and trunk. The lesion had begun shortly after the patient was scratched by prickly okra. The patient had no underlying health problems and he was on no medication. Histology revealed epidermal hyperkeratosis, acanthosis, with papillomatosis with intraepidermal micro‐abscess formation. Within the dermis there was a mixed acute and chronic granulomatous infiltrate. With GMS stain numerous pleomorphic yeast forms and pseudohyphael forms were seen. Cultures confirmed Paecilomyces species. The patient was treated with Voriconazole with complete resolution of his lesion. Paecilomyces is an emerging fungal pathogen, which in our immune competent patient manifest as widespread cutaneous disease.
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