Pheohyphomycosis causes a wide spectrum of clinical presentations. The organisms may be inoculated into the skin or subcutaneous layer after minor trauma. In immunocompetent persons, a solitary skin-colored or erythematous nodule that may resemble a cyst is seen. In immunosuppressed individuals, nodules may be ulcerated, necrotic, or crusted, and these may enlarge progressively. The most common locations are the feet, fingers, knees, toes, ankles, legs, and forearms.
Pheohyphomycosis can be life-threatening when it spreads to the central nervous system, usually after inhalation, by causing brain abscess, meningitis, encephalitis, myelitis, or arachnoiditis. Immunocompromised hosts are at increased risk for a life-threatening disseminated infection after primary inoculation or inhalation and therefore should be treated aggressively.
Other clinical presentations include keratitis, sinusitis, pulmonary disease, or endocarditis.
B48.8 – Other specified mycoses
47158003 – Phaeohyphomycosis
Differential Diagnosis & Pitfalls
- Cutaneous tuberculosis
- Foreign body granuloma
- Cutaneous leishmaniasis
- Mycobacterium marinum infection
- Epidermal inclusion cyst
- Cutaneous metastases
- Squamous cell carcinoma